- Poster presentation
- Open Access
Diffuse fibrosis in dilated cardiomyopathy results in a shorter myocardial null time
© Han et al; licensee BioMed Central Ltd. 2009
- Published: 28 January 2009
- Late Gadolinium Enhancement
- Remote Myocardium
- Diffuse Fibrosis
- Diffuse Myocardial Fibrosis
- Peak Signal Intensity
Ten DCM patients (age 64 ± 8 yr, 70% male) and ten heart-rate matched healthy control subjects (age 26 ± 9 yr, 30% male) were imaged on a 1.5 T Philips Achieva MR scanner (Philips HealthCare, Best, NL), equipped with a 5-element cardiac coil, using standard LGE protocol at 15–20 minutes post 0.2 mmol/kg Gd-DTPA (Magnevist, Berlex, USA) injection. Imaging parameters for the 2D LGE were: 2D spoiled gradient echo inversion recovery, 160 × 160 matrix, 320 cm FOV, 8 mm slices with 2 mm gaps, TR/TE/Flip angle = 4.3 ms/1.5 ms/20°, partial echo, fat saturation, 1 RR between inversions, 2 signal averages. A Look-Locker scan was used to determine the optimal TI performed at 10–15 minutes post-injection with a breath-hold 2D inversion recovery multi-gradient echo sequence with echo train length of 9 views, TR/flip angle = 40 ms/15°, 1 RR between inversions.
Region of interests (ROIs) were used to measure signal to noise ratio and contrast to noise ratio (SNR and CNR) on the short-axis mid-ventricular slice on the septal, anterior, inferior, and lateral walls, and in the blood pool. Noise was measured as the SD of signal in airspace anterior to the chest wall. The Look-Locker data were used to estimate the true zero-crossing for the blood and myocardial signal. ROIs were placed in the LV blood cavity and in the septal wall in each phase of the cardiac cycle. The zero-crossing for the signal was estimated using the linear interpolation between the two time points spanning zero signal intensity.
DCM patients have significantly reduced blood SNR, a shorter optimal TI, and a shorter delta-TI, as predicted by the simulation in Figure 1. This provides evidence for the presence of diffuse fibrosis in patients with DCM. We did not find significant difference in the CNR of the septum vs. the remaining of the walls as reported by others using the remaining walls as remote myocardium. The detection of non-discrete fibrosis is a new aradigm for LGE-CMR.
This article is published under license to BioMed Central Ltd.