Improved border sharpness of post-infarct scar by a novel self-navigated free-breathing high-resolution 3D whole-heart inversion recovery magnetic resonance approach

• Published in: International Journal of Cardiovascular Imaging 2016-12, Vol.32 (12), p.1735-1744
• Main Authors: Rutz, Tobias, Piccini, Davide, Coppo, Simone, Chaptinel, Jerome, Ginami, Giulia, Vincenti, Gabriella, Stuber, Matthias, Schwitter, Juerg
• Format: Article
• Language: English
• Subjects: Aged; Cardiac Imaging; Cardiology; Cicatrix - diagnostic imaging; Contrast Media - administration & dosage; Feasibility Studies; Female; Humans; Image Interpretation, Computer-Assisted; Imaging; Imaging, Three-Dimensional; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardium - pathology; Observer Variation; Organometallic Compounds - administration & dosage; Original Paper; Predictive Value of Tests; Radiology; Reproducibility of Results; Respiration
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-016-0963-4

The border zone of post-infarction myocardial scar as identified by late gadolinium enhancement (LGE) has been identified as a substrate for arrhythmias and consequently, high-resolution 3D scar information is potentially useful for planning of electrophysiological interventions. This study evaluates the performance of a novel high-resolution 3D self-navigated free-breathing inversion recovery magnetic resonance pulse sequence (3D-SN-LGE) vs. conventional 2D breath-hold LGE (2D-LGE) with regard to sharpness of borders (S Border ) of post-infarction scar. Patients with post-infarction scar underwent two magnetic resonance examinations for conventional 2D-LGE and high-resolution 3D-SN-LGE acquisitions (both 15 min after 0.2 mmol/kg Gadobutrol IV) at 1.5T. In the prototype 3D-SN-LGE sequence, each ECG-triggered radial steady-state-free-precession read-out segment is preceded by a non-slice-selective inversion pulse. Scar volume and S Border were assessed on 2D-LGE and matching reconstructed high-resolution 3D-SN-LGE short-axis slices. In 16 patients (four females, 58 ± 10y) all scars visualized by 2D-LGE could be identified on 3D-SN-LGE (time between 2D-LGE and 3D-SN-LGE 48 ± 53 days). A good agreement of scar volume by 3D-SN-LGE vs. 2D-LGE was found (Bland–Altman: −3.7 ± 3.4 ml, correlation: r = 0.987, p