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Magnetic Resonance in Medicine
Article . 2024 . Peer-reviewed
License: CC BY NC
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Serveur académique lausannois
Article . 2024
License: CC BY NC
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Wideband black‐blood late gadolinium enhancement imaging for improved myocardial scar assessment in patients with cardiac implantable electronic devices

Authors: Gut, Pauline; Cochet, Hubert; Caluori, Guido; El‐Hamrani, Dounia; Constantin, Marion; Vlachos, Konstantinos; Sridi, Soumaya; +7 Authors

Wideband black‐blood late gadolinium enhancement imaging for improved myocardial scar assessment in patients with cardiac implantable electronic devices

Abstract

AbstractPurposeWideband phase‐sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) enables myocardial scar imaging in implantable cardioverter defibrillators (ICD) patients, mitigating hyperintensity artifacts. To address subendocardial scar visibility challenges, a 2D breath‐hold single‐shot electrocardiography‐triggered black‐blood (BB) LGE sequence was integrated with wideband imaging, enhancing scar‐blood contrast.MethodsWideband BB, with increased bandwidth in the inversion pulse (0.8–3.8 kHz) and T2 preparation refocusing pulses (1.6–5.0 kHz), was compared with conventional and wideband PSIR, and conventional BB, in a phantom and sheep with and without ICD, and in six patients with cardiac devices and known myocardial injury. ICD artifact extent was quantified in the phantom and specific absorption rate (SAR) was reported for each sequence. Image contrast ratios were analyzed in both phantom and animal experiments. Expert radiologists assessed image quality, artifact severity, and scar segments in patients and sheep. Additionally, histology was performed on the sheep's heart.ResultsIn the phantom, wideband BB reduced ICD artifacts by 62% compared to conventional BB while substantially improving scar‐blood contrast, but with a SAR more than 24 times that of wideband PSIR. Similarly, the animal study demonstrated a considerable increase in scar‐blood contrast with wideband BB, with superior scar detection compared with wideband PSIR, the latter confirmed by histology. In alignment with the animal study, wideband BB successfully eliminated severe ICD hyperintensity artifacts in all patients, surpassing wideband PSIR in image quality and scar detection.ConclusionWideband BB may play a crucial role in imaging ICD patients, offering images with reduced ICD artifacts and enhanced scar detection.

Keywords

Male, Sheep, Phantoms, Imaging, Myocardium, Contrast Media, Gadolinium, Heart, Middle Aged, Image Enhancement, Magnetic Resonance Imaging, Defibrillators, Implantable, Cicatrix, Electrocardiography, Defibrillators, Implantable; Cicatrix/diagnostic imaging; Humans; Animals; Phantoms, Imaging; Sheep; Gadolinium/chemistry; Contrast Media/chemistry; Artifacts; Male; Myocardium/pathology; Magnetic Resonance Imaging; Female; Middle Aged; Aged; Image Processing, Computer-Assisted/methods; Heart/diagnostic imaging; Electrocardiography; Image Enhancement/methods; black‐blood LGE imaging; cardiac implantable electronic device; implantable cardioverter defibrillator; myocardial scar LGE imaging; susceptibility artifacts; wideband LGE imaging, Image Processing, Computer-Assisted, Humans, Animals, Female, Artifacts, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
hybrid