Late gadolinium enhancement cardiac imaging on a 3T scanner with parallel RF transmission technique: prospective comparison of 3D-PSIR and 3D-IR

Abstract

Objective: To qualitatively and quantitatively compare different late gadolinium enhancement (LGE) sequences acquired at 3T with a parallel RF transmission technique.

Methods: One hundred and sixty participants prospectively enrolled underwent a 3T cardiac MRI with 3 different LGE sequences: 3D Phase-Sensitive Inversion-Recovery (3D-PSIR) acquired 5 minutes after injection, 3D Inversion-Recovery (3D-IR) at 9 minutes and 3D-PSIR at 13 minutes. All LGE-positive patients were qualitatively evaluated both independently and blindly by two radiologists using a 4-level scale, and quantitatively assessed with measurement of contrast-to-noise ratio and LGE maximal surface. Statistical analyses were calculated under a Bayesian paradigm using MCMC methods.

Results: Fifty patients (70 % men, 56yo ± 19) exhibited LGE (62 % were post-ischemic, 30 % related to cardiomyopathy and 8 % post-myocarditis). Early and late 3D-PSIR were superior to 3D-IR sequences (global quality, estimated coefficient IR > early-PSIR : -2.37 CI = [-3.46 ; -1.38], prob(coef > 0) = 0 % and late-PSIR > IR : 3.12 CI = [0.62 ; 4.41], prob(coef > 0) = 100 %), LGE surface estimated coefficient IR > early-PSIR: -0.09 CI = [-1.11; -0.74], prob(coef > 0) = 0 % and late-PSIR > IR : 0.96 CI = [0.77; 1.15], prob(coef > 0) = 100 %). Probabilities for late PSIR being superior to early PSIR concerning global quality and CNR were over 90 %, regardless of the aetiological subgroup.

Conclusions: In 3T cardiac MRI acquired with parallel RF transmission technique, 3D-PSIR is qualitatively and quantitatively superior to 3D-IR.

Key points: • Late gadolinium enhancement is an essential part of a cardiac MRI examination • PSIR and IR sequences are the two possible options for LGE imaging • At 3T with parallel RF transmission, PSIR sequences are significantly better • One LGE sequence is sufficient, allowing an optimization of the acquisition time.

Keywords: Cardiac imaging techniques; Late gadolinium enhancement; Magnetic resonance imaging; Parallel radiofrequency transmission; Phase-sensitive inversion recovery.