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T(Rho) and magnetization transfer and INvErsion recovery (TRAMINER)‐prepared imaging: A novel contrast‐enhanced flow‐independent dark‐blood technique for the evaluation of myocardial late gadolinium enhancement in patients with myocardial infarction
Author(s) -
Muscogiuri Giuseppe,
Rehwald Wolfgang G.,
Schoepf U. Joseph,
Suranyi Pal,
Litwin Sheldon E.,
Cecco Carlo N.,
Wichmann Julian L.,
Mangold Stefanie,
Caruso Damiano,
Fuller Stephen R.,
Bayer nd Richard R.,
VargaSzemes Akos
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25498
Subject(s) - medicine , nuclear medicine , magnetic resonance imaging , steady state free precession imaging , confidence interval , myocardial infarction , cardiology , radiology
Purpose To evaluate a new dark‐blood late gadolinium enhancement (LGE) technique called “T(Rho) And Magnetization transfer and INvErsion Recovery” (TRAMINER) for the ability to detect myocardial LGE versus standard “bright‐blood” inversion recovery (SIR) imaging. Materials and Methods This Institutional Review Board (IRB)‐approved, Health Insurance Portability and Accountability Act (HIPAA)‐compliant prospective study included 40 patients (62 ± 14 years [mean ± standard deviation (SD)], 29 males) with suspected myocardial infarction (MI) referred for the assessment of myocardial viability. The patients underwent a 1.5T cardiac magnetic resonance imaging (MRI) including postcontrast SIR and TRAMINER acquisitions. Normalized images were evaluated by two readers. Subjective (3‐point Likert scale) and objective image qualities were compared using Mann–Whitney U ‐test and paired t ‐test, respectively. Interobserver agreement, LGE detection rate, and level of certainty were compared using Cohen's kappa, Wilcoxon‐test, and Mann–Whitney U ‐test, respectively. Results are reported as mean ± SD or mean [95% confidence interval]. Results Overall, image quality was rated similar between TRAMINER and SIR; however, TRAMINER performed better on a visual assessment of the ability to differentiate LGE from blood (Likert scale: 3.0 [3.0–3.0] vs. 2.0 [1.7–2.2], P < 0.0001). TRAMINER provided significantly higher signal intensity range (69.8 ± 10.2 vs. 9.6 ± 7.6, P < 0.0001) and a 4‐fold higher signal intensity ratio (4.2 ± 1.9 vs. 1.1 ± 0.1, P < 0.0001) between LGE and blood signals. TRAMINER detected more patients (19/40 vs. 17/40) and segments (91/649 vs. 79/649) with LGE with higher level of certainty (2.9 [2.8–3.0] vs. 2.7 [2.5–2.8], P = 0.0185). Interobserver agreement was good to excellent for LGE detection. Conclusion TRAMINER provides better contrast between LGE and blood and consequently may have increased ability to discriminate thin subendocardial and papillary muscle enhancement from the blood signal, which can have an indistinct appearance using SIR. Level of Evidence : 2 J. MAGN. RESON. IMAGING 2017;45:1429–1437