Clinical value of dark-blood late gadolinium enhancement cardiovascular magnetic resonance without additional magnetization preparation

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dc.contributor.authorBotnar, René Michael
dc.contributor.authorHoltackers, Robert J.
dc.contributor.authorVan De Heyning, Caroline M.
dc.contributor.authorNazir, Muhummad Sohaib.
dc.contributor.authorRashid, Imran.
dc.contributor.authorNtalas, Ioannis.
dc.contributor.authorRahman, Haseeb.
dc.contributor.authorChiribiri, Amedeo.
dc.date.accessioned2019-10-17T13:59:50Z
dc.date.available2019-10-17T13:59:50Z
dc.date.issued2019
dc.date.updated2019-10-14T19:01:20Z
dc.description.abstractAbstract Background For two decades, bright-blood late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been considered the reference standard for the non-invasive assessment of myocardial viability. While bright-blood LGE can clearly distinguish areas of myocardial infarction from viable myocardium, it often suffers from poor scar-to-blood contrast, making subendocardial scar difficult to detect. Recently, we proposed a novel dark-blood LGE approach that increases scar-to-blood contrast and thereby improves subendocardial scar conspicuity. In the present study we sought to assess the clinical value of this novel approach in a large patient cohort with various non-congenital ischemic and non-ischemic cardiomyopathies on both 1.5 T and 3 T CMR scanners of different vendors. Methods Three hundred consecutive patients referred for clinical CMR were randomly assigned to a 1.5 T or 3 T scanner. An entire short-axis stack and multiple long-axis views were acquired using conventional phase sensitive inversion recovery (PSIR) LGE with TI set to null myocardium (bright-blood) and proposed PSIR LGE with TI set to null blood (dark-blood), in a randomized order. The bright-blood LGE and dark-blood LGE images were separated, anonymized, and interpreted in a random order at different time points by one of five independent observers. Each case was analyzed for the type of scar, per-segment transmurality, papillary muscle enhancement, overall image quality, observer confidence, and presence of right ventricular scar and intraventricular thrombus. Results Dark-blood LGE detected significantly more cases with ischemic scar compared to conventional bright-blood LGE (97 vs 89, p = 0.008), on both 1.5 T and 3 T, and led to a significantly increased total scar burden (3.3 ± 2.4 vs 3.0 ± 2.3 standard AHA segments, p = 0.015). Overall image quality significantly improved using dark-blood LGE compared to bright-blood LGE (81.3% vs 74.0% of all segments were of highest diagnostic quality, p = 0.006). Furthermore, dark-blood LGE led to significantly higher observer confidence (confident in 84.2% vs 78.4%, p = 0.033). Conclusions The improved detection of ischemic scar makes the proposed dark-blood LGE method a valuable diagnostic tool in the non-invasive assessment of myocardial scar. The applicability in routine clinical practice is further strengthened, as the present approach, in contrast to other recently proposed dark- and black-blood LGE techniques, is readily available without the need for scanner adjustments, extensive optimizations, or additional training.
dc.fuente.origenBiomed Central
dc.identifier.citationJournal of Cardiovascular Magnetic Resonance. 2019 Jul 29;21(1):44
dc.identifier.doi10.1186/s12968-019-0556-1
dc.identifier.urihttps://doi.org/10.1186/s12968-019-0556-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26662
dc.identifier.wosidWOS:000477713400001
dc.issue.numeroNo. 44
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final11
dc.pagina.inicio1
dc.revistaJournal of Cardiovascular Magnetic Resonancees_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s).
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.subject.otherMiocardioes_ES
dc.subject.otherCicatrizes_ES
dc.subject.otherCorazón - Imagenes_ES
dc.subject.otherResonancia magnéticaes_ES
dc.titleClinical value of dark-blood late gadolinium enhancement cardiovascular magnetic resonance without additional magnetization preparationes_ES
dc.typeartículo
dc.volumenVol. 21
sipa.codpersvinculados1015313
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