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Background Focal fibrosis is visible as late gadolinium enhancement when using inversion recovery (IR) imaging late after a contrast bolus and carries major clinical import. The IR technique results in high sensitivity to regional T1 variation but sacrifices absolute quantification meaning that differing degrees of focal interstitial expansion will look the same (bright). We hypothesized that LGE in different disease processes would have different degrees of interstitial expansion. We used equilibrium contrast CMR (EQ-CMR), to measure the degree of interstitial expansion by measuring the volume of distribution of contrast, Vd(m).

Not all LGE is the same. Scar contrast volume of distribution is lower in HCM than in infarction