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Methods Imaging was performed using a 1.5 T or 3 T Siemens scanner in patients with known or suspected cardiomyopathy. Serial short axis DE imaging was performed using a PSIRtFL pulse sequence with the TI time adjusted to optimally null normal myocardium on magnitude images. Semiautomated scar volumes were calculated for matched PC and UC-DE images at 2, 3 and 5 standard deviation (SD) above normal myocardium and compared using a two tailed paired-sample Student's t-test. Pearson correlation coefficients were calculated and linear regression analysis performed for PC versus UC methods. Scar border-zone was calculated for the ischemic sub-group using the difference between 3 and 5 SD thresholds and compared in the same fashion. Results 119 patients were evaluated. The mean LVEF was 52 ± 21%. A total of 79 patients (66%) demonstrated abnormal DE, 40 with ischemic scar and 39 with non-ischemic scar (epicardial-based or mid-wall). Linear regression of scar volumes from PC and NC images is shown in Figure 1 (a-c). PC and NC scar volumes for ischemic scar at 2, 3 and 5 SD cut-offs were 36.5 ± 14.1% versus 41.0 ± 15.2%, 27.9 ± 13.9% versus 32.4 ± 15.1%, and 17.8 ± 12.0% versus 22.4 ± 13.8%, respectively (p < 0.001 for all comparisons). A similar relationship was seen for non-ischemic scar at each of the thresholds (23.0 ± 14.9% versus 30.2 ± 15.9%, 13.4 ± 12.5% versus 19.3 ± 13.2%, and 5.2 ± 8.1% versus 8.8 ± 9.1%, respectively (p < 0.001 for all comparisons)). Pearson correlation coefficients at 2, 3, and 5, SD thresholds were 0.91, 0.94, and 0.96 (p < 0.001), respectively. For ischemic DE a significant difference was seen in scar border-zone between PC and UC images (8.3 ± 5.7 and 10.5 ± 6.1 (p = 0.04), respectively). The correlation coefficient for scar border-zone was r = 0.69 (p < 0.001).

journal of cardiovascular magnetic resonance

Comparison of myocardial scar quantification using phase sensitive inversion recovery (PSIR) versus conventional IR-tLF techniques in patients with ischemic and non-ischemic cardiomyopathy