Background
Papillary muscle scarring may result in mitral regurgitation and may be foci for ventricular arrhythmias. However, papillary muscle scarring may be difficult to detect with delayed enhancement MRI (DE-MRI) since there is often poor contrast between hyperenhanced tissue and immediately adjacent bright blood pool. We have developed a new, Flow-Independent Dark-blood DeLayed Enhancement technique (FIDDLE) that increases conspicuity of areas of myocardial scar adjacent to the blood pool. We validated FIDDLE in detecting papillary muscle scar in an animal model of myocardial infarction (MI) and demonstrate feasibility in patients with MI.