Wideband black-blood late gadolinium enhancement imaging for improved myocardial scar assessment in patients with cardiac implantable electronic devices.
Details
State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_37B98BCD67A8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Wideband black-blood late gadolinium enhancement imaging for improved myocardial scar assessment in patients with cardiac implantable electronic devices.
Journal
Magnetic resonance in medicine
ISSN
1522-2594 (Electronic)
ISSN-L
0740-3194
Publication state
Published
Issued date
11/2024
Peer-reviewed
Oui
Volume
92
Number
5
Pages
1851-1866
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Wideband 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.
Wideband BB, with increased bandwidth in the inversion pulse (0.8-3.8 kHz) and T <sub>2</sub> 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.
In 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.
Wideband BB may play a crucial role in imaging ICD patients, offering images with reduced ICD artifacts and enhanced scar detection.
Wideband BB, with increased bandwidth in the inversion pulse (0.8-3.8 kHz) and T <sub>2</sub> 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.
In 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.
Wideband BB may play a crucial role in imaging ICD patients, offering images with reduced ICD artifacts and enhanced scar detection.
Keywords
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
Pubmed
Web of science
Open Access
Yes
Create date
14/06/2024 16:38
Last modification date
27/08/2024 7:23