Equivalence of conventional and fast late gadolinium enhancement (LGE) techniques for quantitative evaluation of fibrosis in ischemic and non-ischemic cardiac disease - Save the Time!

Methods Patients with myocardial infarction (n = 45), myocarditis (n = 25) or hypertrophic cardiomyopathy (HCM) (n = 15) were prospectively enrolled. After administration of gadolinium contrast agent, LGE images were acquired ECG-gated in short axis slices (slice thickness 7 mm, no gap) using 4 different LGE sequences: (1) conventional segmented 2D phase-sensitive inversion recovery in single-slice/single-breath-hold technique (2D-PSIR; gold standard; TR 744 ms, TE 5,17 ms, voxel size 1.4 × 1.4 × 7.0 mm), (2) single-breath-hold 3D-IR sequence (3D-IR bh; TR 924 ms, TE 1.06 ms, voxel size 1.9 × 1.9 × 7.0 mm), (3) single breath-hold 3D-SSFP sequence (3DSSFP; TE 700 ms, TE 1.05 ms, voxel size 1.9 × 1.9 × 7.0 mm) and (4) non-breath-hold technique (3D-IR nbh). (Figure 1) For all techniques, inversion time was individually adjusted to null the remote myocardium. Myocardial fibrosis was quantitatively assessed using a semiautomated threshold method; positive LGE was defined as signal intensity 6 standard deviations (SD) above signal intensity of remote myocardium for myocardial infarction and 3 SD for myocarditis / HCM. Detection rates were determined as number of matching myocardial AHA segments with detected LGE in gold standard and each fast technique.