3D Whole-heart Grey-blood Late Gadolinium Enhancement Imaging

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Abstract

Purpose: To develop a free-breathing whole-heart isotropic-resolution 3D late gadolinium enhancement (LGE) sequence with Dixon-encoding, which provides co-registered 3D grey-blood PSIR (phase-sensitive inversion-recovery) and complementary 3D fat volumes in a single scan of <7 min. Methods: A free-breathing 3D PSIR LGE sequence with dual-echo Dixon readout with a variable density Cartesian trajectory with acceleration factor of 3 is proposed. Image navigators are acquired to correct both IR-prepared and reference volumes for 2D translational respiratory motion, enabling motion compensated PSIR reconstruction with 100% respiratory scan efficiency. An intermediate PSIR reconstruction is performed between the in-phase echoes to estimate the signal polarity which is subsequently applied to the IR-prepared water volume to generate a water grey-blood PSIR image. The IR-prepared water volume is obtained using a water/fat separation algorithm from the corresponding dual-echo readout. The complementary fat-volume is obtained after water/fat separation of the reference volume. Ten patients (6 with myocardial scar) were scanned with the proposed water/fat grey-blood 3D PSIR LGE sequence at 1.5T and compared to breath-held grey-blood 2D LGE sequence in terms of contrast ratio (CR), contrast-to-noise ratio (CNR), scar depiction, scar transmurality, scar mass and image quality. Results: Comparable CRs (p=0.98, 0.40 and 0.83) and CNRs (p=0.29, 0.40 and 0.26) for blood-myocardium, scar-myocardium and scar-blood respectively) were obtained with the proposed free-breathing 3D water/fat LGE and 2D clinical LGE scan. Excellent agreement for scar detection, scar transmurality, scar mass (bias = 0.29%) and image quality scores (from 1: non-diagnostic to 4: excellent) of 3.8±0.42 and 3.6±0.69 (p>0.99) were obtained with the 2D and 3D PSIR LGE approaches with comparable total acquisition time (p=0.29). Similar agreement in intra and inter-observer variability were obtained for the 2D and 3D acquisition respectively. Conclusion: The proposed approach enabled the acquisition of free-breathing motion-compensated isotropic-resolution 3D grey-blood PSIR LGE and fat volumes. The proposed approach showed good agreement with conventional 2D LGE in terms of contrast ratio, scar depiction and scan time, while enabling free-breathing acquisition, whole-heart coverage, reformatting in arbitrary views and visualization of both water and fat information.
Original languageEnglish
JournalJournal of Cardiovascular Magnetic Resonance
Publication statusAccepted/In press - 29 Mar 2021

Keywords

  • 3D whole-heart, respiratory motion correction, Late gadolinium enhancement, Dixon water/fat separation

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