Fig. 4

Short-axis bright-blood and dark-blood LGE image of all eight discordant cases. Conventional bright-blood (upper row) and dark-blood (lower row) phase sensitive inversion recovery (PSIR) LGE short-axis images of all eight discordant cases. Areas of infarction are indicated by blue arrows. Note that these areas of infarction could have been recognized using conventional bright-blood LGE when the dark-blood images would have been shown simultaneously. However, when only the conventional bright-blood images were shown, these areas were missed and the patients were declared free of any ischemic scar, while dark-blood LGE showed clear hyperenhancement. Patient 2, 3, 4, 5, 6, and 8 had known coronary artery disease. In each patient, the yellow star indicates which method was performed first (at 10 min), while the two letters indicate the CMR system used for each study (see Table 1 for specific scan details, PI = Philips 1.5T Ingenia, SA = Siemens 1.5T Aera, PA = Philips 3T Achieva TX)