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Three-dimensional Dixon fat-water separated breath-held imaging of myocardial delayed enhancement


Myocardial delayed enhancement (MDE) imaging of infarction is commonly performed using an inversion-recovery (IR) two-dimensional (2D) breath-held fast gradient recalled echo (FGRE) pulse sequence. Three-dimensional (3D) imaging can improve scanning efficiency by acquiring the desired volume in a single breath-hold. Fat suppression could greatly improve visualization of epicardial enhancement (which occurs in transmural myocardial infarction and myocarditis) as well as pericardial enhancement.


To investigate a novel Dixon fat-water separated 3D breath-hold technique for fat suppressed imaging of MDE.


An ECG-gated dual-echo bipolar-readout 3DFGRE pulse sequence was developed. High receiver bandwidths enabled placement of opposed- and in-phase echoes at 2.4/4.8 ms, achieving compact TRs. Elimination of explicit fat suppression enabled use of a novel k-space segmentation scheme that is efficient and has desirable motion insensitivity properties. Radial fanbeam k-space segmentation of an elliptical ky-kz region (corners skipped) was employed for efficient coverage of k-space, enabling 3D data acquisition in a single breath-hold. Within each fanbeam, k-space points were acquired in the order of increasing kr. In each R-R interval, a non-selective 180° pulse followed by an inversion time (TI) delay of 200-250 ms preceded data acquisition at ~300 ms (32-36 points). A self-calibrated parallel imaging scheme with acceleration factor of 2.5 in the phase encoding direction yielded an overall breath-holding time of 22-25 s. A robust region-growing based phase-corrected 2-point Dixon reconstruction algorithm of Ma et al. was used. Patients with known or suspected myocardial infarction, myocarditis, pericarditis, or non-ischemic cardiomyopathy were imaged after informed consent on a 1.5 T GE SIGNA scanner using an 8-channel phased array coil. Imaging was performed approximately 10-15 minutes after bolus injection of 0.2 mmol/kg of Gadolinium DTPA contrast agent. The 3D Dixon FGRE scan immediately followed the IR prepared 2D FGRE acquisition.


Figure 1 compares conventional 2D MDE with 3D Dixon MDE in a patient with an inferior infarct demonstrating better SNR and spatial resolution of the 3D sequence. Figure 2 compares conventional 2D MDE and 3D Dixon MDE in a patient with pericarditis clearly showing improved visualization of pericardial enhancement in the 3D Dixon sequence.

Figure 1
figure 1

Short axis 2D MDE (left) and 3D Medal MDE (right) images in patient with inferior/inferoseptal infarct demonstrate transmural delayed enhancement.

Figure 2
figure 2

Short axis 2D MDE (left) and 3D Medal MDE images (right) in a patient with pericarditis. Pericardial enhancement is more clearly deomnstrated in the fat-suppressed Medal MDE image (right).


A technique capable of providing full heart coverage in a single 3D breath-held acquisition was validated. The use of Dixon based fat-water separation makes the technique immune to Bo inhomogeneities, improving SNR as well as fat suppression. The novel radial fan-beam k-space segmentation enabled acquisition of a 3D slab in a short breath-hold.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Saranathan, M., Glockner, J.F. Three-dimensional Dixon fat-water separated breath-held imaging of myocardial delayed enhancement. J Cardiovasc Magn Reson 12 (Suppl 1), P102 (2010).

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