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Border sharpness of scar tissue after myocardial infarction as determined by self-navigated free-breathing isotropic 3D whole-heart inversion recovery magnetic resonance
© Rutz et al. 2016
- Published: 27 January 2016
- Myocardial Infarction
- Cardiac Magnetic Resonance
- Late Gadolinium Enhancement
- Blood Pool
- Magnetic Resonance Scanner
The border zone of myocardial scar after myocardial infarction (MI) plays an important role for arrhythmia formation. For this reason, high-resolution 3D information of scar tissue for planning of electrophysiological interventions after MI is highly desirable. This study evaluates sharpness of the borders (SB) of scar after MI by a self-navigated isotropic 3D free-breathing whole-heart magnetic resonance with inversion recovery (3DSN-IR) in comparison to a standard 2D inversion recovery sequence.
Patients after MI detected by 2D late gadolinium enhancement (2D LGE) on a standard 2D inversion recovery sequence (resolution 1.3 mm2, 8 mm slice thickness) underwent 3DSN-IR on a 1.5T cardiac magnetic resonance scanner (MAGNETOM Aera, Siemens). Data acquisition was performed during the most quiescent systolic phase with a prototype 3D radial trajectory with self-navigation  after administration of 0.2 mmol/kg of Gadobutrol. A non-selective IR pulse was added prior to each acquired k-space segment to the segmented, ECG-triggered, fat-saturated radial SSFP imaging sequence with an isovolumetric resolution of 1.15 mm3. Inversion time was assessed with a 2D radial scout scan prior to 3DSN-IR. To determine SB, a customized software was used to calculate signal intensity gradients between two regions . SB in mm-1 of borders "blood pool to scar", "blood pool to non-infarcted myocardium" and "scar to non-infarcted myocardium" were compared between a 2D LGE short-axis slice with 8 mm slice thickness and two corresponding reconstructed 3DSN-IR short-axis slices, one with isovolumetric voxel size (1.15 mm3) and the second interpolated to 8 mm slice thickness, all at the same anatomical location.
Thirteen patients (5 females, 58 ± 10 y, time between 2D LGE and 3D LGE 59 ± 64 days) were included. All scars visualized by 2D LGE could be identified by 3DSN-IR. SB was significantly better in 3DSN-IR compared to 2D LGE for the borders "blood pool to non-infarcted myocardium" and "scar to non-infarcted myocardium". There was a trend to a better SB for 3DSN-IR images for the border "blood pool to scar" (see table and figure).
Border sharpness of 2D LGE and 3DSN-IR images. Border sharpness of "blood pool to non-infarcted myocardium"," blood pool to scar" and "non-infarcted myocardium to scar" in mm-1. Data are mean ± standard deviation or range (interquartile) where appropriate.
3DSN-IR isovolumetric voxel (1.15 mm)
3DSN-IR 8 mm slice thickness
Blood pool - non-infarcted myocardium
0.029 (0.022, 0.058)*
0.067 (0.04, 0.095)
0.071 (0.051, 0.10)
Blood pool - scar
0.083 ± 0.056
0.121 ± 0.070
0.124 ± 0.070
Scar - non-infarcted myocardium
0.079 ± 0.034†
0.171 ± 0.086
0.172 ± 0.074
- Piccini D, et al: Respiratory self-navigation for whole-heart bright-blood coronary MRI: methods for robust isolation and automatic segmentation of the blood pool. Magn Reson Med. 2012, 68 (29): P75-9.Google Scholar
- Kording F, et al: Doppler ultrasound compared with electrocardiogram and pulse oximetry cardiac triggering: A pilot study. Magn Reson Med. 2014Google Scholar
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