Left atrial wall imaging using a novel black-blood late gadolinium enhancement sequence

Background Late gadolinium enhancement (LGE) is commonly used clinically to identify myocardial infarct or scar as a hyper-enhanced region. However, the blood pool also remains bright in such images, masking adjacent bright tissue. LGE has also been used extensively to image fibrosis in the left atrium (LA) in patients with atrial fibrillation. However, identification of LA wall in LGE is challenging due to the thin wall of LA and high signal of the blood pool in the LA. We recently developed a novel black-blood LGE (BB-LGE) sequence (Fig. 1) which uses an optimized combination of inversionrecovery and T2-preparation (T2-prep) prepulses to simultaneously null the healthy myocardium and blood signals by leveraging the higher T2 of blood. In this study, we sought to assess the feasibility of BB-LGE in imaging of LA.