Improved late gadolinium enhancement imaging of left ventricle with isotropic spatial resolution

Abstract Background Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) represents the gold standard for assessment of myocardial viability. The purpose of this study was to investigate the clinical potential of Compressed SENSE (factor 5) accelerated free-breathing three-dimensional (3D) whole heart LGE with high isotropic spatial resolution (1.4 mm3 acquired voxel size) compared to standard breath-hold LGE imaging. Methods This was a retrospective, single-center study of 70 consecutive patients (45.8 ± 18.1 years, 27 females; February–November 2019), who were referred for assessment of left ventricular myocardial viability and received free-breathing and breath-hold LGE sequences at 1.5 T in clinical routine. Two radiologists independently evaluated global and segmental LGE in terms of localization and transmural extent. Readers scored scans regarding image quality (IQ), artifacts, and diagnostic confidence (DC) using 5-point scales (1 non-diagnostic—5 excellent/none). Effects of heart rate and body mass index (BMI) on IQ, artifacts, and DC were evaluated with ordinal logistic regression analysis. Results Global LGE (n = 33) was identical for both techniques. Using free-breathing LGE (average scan time: 04:33 ± 01:17 min), readers detected more hyperenhanced lesions (28.2% vs. 23.5%, P < .05) compared to breath-hold LGE (05:15 ± 01:23 min, P = .0104), pronounced at subepicardial localization and for 1–50% of transmural extent. For free-breathing LGE, readers graded scans with good/excellent IQ in 80.0%, with low-impact/no artifacts in 78.6%, and with good/high DC in 82.1% of cases. Elevated BMI was associated with increased artifacts (P = .0012) and decreased IQ (P = .0237). Increased heart rate negatively influenced artifacts (P = .0013) and DC (P = .0479) whereas IQ (P = .3025) was unimpaired. Conclusions In a clinical setting, free-breathing Compressed SENSE accelerated 3D high isotropic spatial resolution whole heart LGE provides good to excellent image quality in 80% of scans independent of heart rate while enabling improved depiction of small and particularly non-ischemic hyperenhanced lesions in a shorter scan time than standard breath-hold LGE.

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Accelerated Late Gadolinium Enhancement Cardiac MR Imaging with Isotropic Spatial Resolution Using Compressed Sensing: Initial Experience

Radiology ◽

10.1148/radiol.12112489 ◽

2012 ◽

Vol 264 (3) ◽

pp. 691-699 ◽

Cited By ~ 55

Author(s):

Mehmet Akçakaya ◽

Hussein Rayatzadeh ◽

Tamer A. Basha ◽

Susie N. Hong ◽

Raymond H. Chan ◽

...

Keyword(s):

Late Gadolinium Enhancement ◽

Mr Imaging ◽

Compressed Sensing ◽

Spatial Resolution ◽

Initial Experience ◽

Gadolinium Enhancement ◽

Cardiac Mr ◽

Isotropic Spatial Resolution

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Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes

Cardiovascular Diabetology ◽

10.1186/s12933-020-01160-y ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Annemie Stege Bojer ◽

Martin Heyn Sørensen ◽

Niels Vejlstrup ◽

Jens P. Goetze ◽

Peter Gæde ◽

...

Keyword(s):

Type 2 Diabetes ◽

Late Gadolinium Enhancement ◽

Left Ventricle ◽

Stress Perfusion ◽

Gadolinium Enhancement ◽

Unique Identifier ◽

Maximal Volume ◽

Ischemic Lesion ◽

Control Subjects

Abstract Background Cardiovascular magnetic resonance imaging (CMR) have described localised non-ischemic late gadolinium enhancement (LGE) lesions of prognostic importance in various non-ischemic cardiomyopathies. Ischemic LGE lesions are prevalent in diabetes (DM), but non-ischemic LGE lesions have not previously been described or systematically studied in DM. Methods 296 patients with type 2 DM (T2DM) and 25 sex-matched control subjects underwent echocardiography and CMR including adenosine-stress perfusion, T1-mapping and LGE. Results 264 patients and all control subjects completed the CMR protocol. 78.4% of patients with T2DM had no LGE lesions; 11.0% had ischemic LGE lesions only; 9.5% had non-ischemic LGE lesions only; and 1.1% had both one ischemic and one non-ischemic lesion. The non-ischemic LGE lesions were situated mid-myocardial in the basal lateral or the basal inferolateral part of the left ventricle and the affected segments showed normal to high wall thickness and normal contraction. Patients with non-ischemic LGE lesions in comparison with patients without LGE lesions had increased myocardial mass (150 ± 34 vs. 133 ± 33 g, P = 0.02), average E/e’(9.9 IQR8.7–12.6 vs. 8.8 IQR7.4–10.7, P = 0.04), left atrial maximal volume (102 IQR84.6–115.2 vs. 91 IQR75.2–100.0 mL, P = 0.049), NT-proBNP (8.9 IQR5.9–19.7 vs. 5.9 IQR5.9–10.1 µmol/L, P = 0.02) and high-sensitive troponin (15.6 IQR13.0–26.1 vs. 13.0 IQR13.0–14.6 ng/L, P = 0.007) and a higher prevalence of retinopathy (48 vs. 25%, P = 0.009) and autonomic neuropathy (52 vs. 30.5%, P = 0.005). Conclusion A specific LGE pattern with lesions in the basal lateral or the basal inferolateral part of the left ventricle was found in patients with type 2 diabetes. Trial registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT02684331.

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