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Improved dark blood late gadolinium enhancement (DB‐LGE) imaging using an optimized joint inversion preparation and T 2 magnetization preparation
Author(s) -
Basha Tamer A.,
Tang Maxine C.,
Tsao Connie,
Tschabrunn Cory M.,
Anter Elad,
Manning Warren J.,
Nezafat Reza
Publication year - 2018
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.26692
Subject(s) - gadolinium , nuclear medicine , imaging phantom , medicine , magnetic resonance imaging , contrast (vision) , image quality , nuclear magnetic resonance , materials science , radiology , physics , optics , computer science , artificial intelligence , metallurgy , image (mathematics)
Purpose To develop a dark blood–late gadolinium enhancement (DB‐LGE) sequence that improves scar–blood contrast and delineation of scar region. Methods The DB‐LGE sequence uses an inversion pulse followed by T 2 magnetization preparation to suppress blood and normal myocardium. Time delays inserted after preparation pulses and T 2 ‐magnetization‐prep duration are used to adjust tissue contrast. Selection of these parameters was optimized using numerical simulations and phantom experiments. We evaluated DB‐LGE in 9 swine and 42 patients (56 ± 14 years, 33 male). Improvement in scar–blood contrast and overall image quality was subjectively evaluated by two independent readers (1 = poor, 4 = excellent). The signal ratios among scar, blood, and myocardium were compared. Results Simulations and phantom studies demonstrated that simultaneous nulling of myocardium and blood can be achieved by selecting appropriate timing parameters. The scar–blood contrast score was significantly higher for DB‐LGE ( P < 0.001) with no significant difference in overall image quality ( P > 0.05). Scar–blood signal ratios for DB‐LGE versus LGE were 5.0 ± 2.8 versus 1.5 ± 0.5 ( P < 0.001) for patients, and 2.2 ± 0.7 versus 1.0 ± 0.4 ( P = 0.0023) for animals. Scar–myocardium signal ratios were 5.7 ± 2.9 versus 6.3 ± 2.6 ( P = 0.35) for patients, and 3.7 ± 1.1 versus 4.1 ± 2.0 ( P = 0.60) for swine. Conclusions The DB‐LGE sequence simultaneously reduces normal myocardium and blood signal intensity, thereby enhancing scar–blood contrast while preserving scar–myocardium contrast. Magn Reson Med 79:351–360, 2018. © 2017 International Society for Magnetic Resonance in Medicine.