PMID- 27817748 OWN - NLM STAT- MEDLINE DCOM- 20171212 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 18 IP - 1 DP - 2016 Nov 7 TI - Dark blood late enhancement imaging. PG - 77 LID - 77 AB - BACKGROUND: Bright blood late gadolinium enhancement (LGE) imaging typically achieves excellent contrast between infarcted and normal myocardium. However, the contrast between the myocardial infarction (MI) and the blood pool is frequently suboptimal. A large fraction of infarctions caused by coronary artery disease are sub-endocardial and thus adjacent to the blood pool. It is not infrequent that sub-endocardial MIs are difficult to detect or clearly delineate. METHODS: In this present work, an inversion recovery (IR) T2 preparation was combined with single shot steady state free precession imaging and respiratory motion corrected averaging to achieve dark blood LGE images with good signal to noise ratio while maintaining the desired spatial and temporal resolution. In this manner, imaging was conducted free-breathing, which has benefits for image quality, patient comfort, and clinical workflow in both adults and children. Furthermore, by using a phase sensitive inversion recovery reconstruction the blood signal may be made darker than the myocardium (i.e., negative signal values) thereby providing contrast between the blood and both the MI and remote myocardium. In the proposed approach, a single T1-map scout was used to measure the myocardial and blood T1 using a MOdified Look-Locker Inversion recovery (MOLLI) protocol and all protocol parameters were automatically calculated from these values within the sequence thereby simplifying the user interface. RESULTS: The contrast to noise ratio (CNR) between MI and remote myocardium was measured in n = 30 subjects with subendocardial MI using both bright blood and dark blood protocols. The CNR for the dark blood protocol had a 13 % loss compared to the bright blood protocol. The CNR between the MI and blood pool was positive for all dark blood cases, and was negative in 63 % of the bright blood cases. The conspicuity of subendocardial fibrosis and MI was greatly improved by dark blood (DB) PSIR as well as the delineation of the subendocardial border. CONCLUSIONS: Free-breathing, dark blood PSIR LGE imaging was demonstrated to improve the visualization of subendocardial MI and fibrosis in cases with low contrast with adjacent blood pool. The proposed method also improves visualization of thin walled fibrous structures such as atrial walls and valves, as well as papillary muscles. FAU - Kellman, Peter AU - Kellman P AUID- ORCID: 0000-0002-9875-6070 AD - National Heart, Lung, and Blood Institute, National Institutes of Health, DHHS, 10 Center Drive MSC-1061, Bethesda, MD, 20892, USA. kellman@nih.gov. FAU - Xue, Hui AU - Xue H AD - National Heart, Lung, and Blood Institute, National Institutes of Health, DHHS, 10 Center Drive MSC-1061, Bethesda, MD, 20892, USA. FAU - Olivieri, Laura J AU - Olivieri LJ AD - Children's National Medical Center, 111 Michigan Ave., N.W, Washington, DC, 20010, USA. FAU - Cross, Russell R AU - Cross RR AD - Children's National Medical Center, 111 Michigan Ave., N.W, Washington, DC, 20010, USA. FAU - Grant, Elena K AU - Grant EK AD - Children's National Medical Center, 111 Michigan Ave., N.W, Washington, DC, 20010, USA. FAU - Fontana, Marianna AU - Fontana M AD - National Amyloidosis Centre, University College London (UCL) Medical School, Royal Free Hospital, London, UK. FAU - Ugander, Martin AU - Ugander M AD - Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. FAU - Moon, James C AU - Moon JC AD - Barts Heart Centre, St. Bartholomew's Hospital, London, UK. FAU - Hansen, Michael S AU - Hansen MS AD - National Heart, Lung, and Blood Institute, National Institutes of Health, DHHS, 10 Center Drive MSC-1061, Bethesda, MD, 20892, USA. LA - eng GR - FS/10/40/28260/BHF_/British Heart Foundation/United Kingdom GR - FS/12/56/29723/BHF_/British Heart Foundation/United Kingdom PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Validation Study DEP - 20161107 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 RN - 0 (Contrast Media) SB - IM MH - Automation MH - Contrast Media/*administration & dosage MH - District of Columbia MH - Fibrosis MH - Humans MH - Image Interpretation, Computer-Assisted MH - London MH - Magnetic Resonance Imaging/*methods MH - Myocardial Infarction/blood/*diagnostic imaging/pathology MH - Myocardium/*pathology MH - Pilot Projects MH - Predictive Value of Tests MH - Reproducibility of Results MH - Respiration MH - Signal-To-Noise Ratio MH - Sweden MH - User-Computer Interface MH - Workflow PMC - PMC5098284 OTO - NOTNLM OT - Ablation OT - Dark blood OT - Gadolinium OT - LGE OT - Late enhancement OT - MOCO OT - Myocardial infarction OT - PSIR OT - Scar EDAT- 2016/11/08 06:00 MHDA- 2017/12/13 06:00 PMCR- 2016/11/07 CRDT- 2016/11/08 06:00 PHST- 2016/08/18 00:00 [received] PHST- 2016/10/18 00:00 [accepted] PHST- 2016/11/08 06:00 [entrez] PHST- 2016/11/08 06:00 [pubmed] PHST- 2017/12/13 06:00 [medline] PHST- 2016/11/07 00:00 [pmc-release] AID - S1097-6647(23)01018-9 [pii] AID - 297 [pii] AID - 10.1186/s12968-016-0297-3 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2016 Nov 7;18(1):77. doi: 10.1186/s12968-016-0297-3.