Olivier Cappeliez, Presenter: Nothing to Disclose

Stéphane Baldassarre MD, Abstract Co-Author: Nothing to Disclose

Nathalie Gauquier MD, Abstract Co-Author: Nothing to Disclose

Jean Jacquy MD, Abstract Co-Author: Nothing to Disclose

Jacques Van Espen, Abstract Co-Author: Nothing to Disclose

Luisa Divano MD, Abstract Co-Author: Nothing to Disclose

To compare IR-trueFISP and IR-TFL sequences with respect to image quality and myocardial viability assessment

46 consecutive patients were imaged for viability assessment 15 minutes after intravenous contrast injection. The imaging protocol included the same views using both IR-trueFISP and IR-TFL. Image quality was rated: good, sufficient, or insufficient. 43 patients with good or sufficient image quality rating for both techniques were selected for comparison. The left ventricle was divided in 17 segments. A total of 86 contrast-enhanced left ventricles (731 segments), both IR-trueFISP and IR-TFL, were analyzed in random order by two observers blinded to patient’s identity and clinical data. Each segment was graded on a 3-point scale: 0 = no hyperenhancement; 1 = up to 75% hyperenhancement; 2 = more than 75% hyperenhancement. The sum of all 17 segments score yielded the total hyperenhancement score (THS).

Observer agreement was almost perfect for image quality rating (Kappa > 0,81 for both sequences). There was no statistically significant difference in image quality rating between IR-TFL and IR-trueFISP when 3 patients with insufficient image quality rating are rejected. Also, no statistically significant difference was found in hyperenhancement grading between IR-TFL and IR-trueFISP. Hyperenhancement visualized by IR-TFL was identified by IR-trueFISP in 145 of 154 segments. Sensitivity and specificity of IR-trueFISP were 94.2% and 100% respectively. Positive and negative predictive values were 100% and 98.5% respectively. There were 9 false negative segments in 2 patients with very thin-walled left ventricles. In two other segments (one patient) hyperenhancement was graded 2 with IR-TFL and 1 with IR-trueFISP.

IR-trueFISP produces an image quality that is comparable to IR-TFL. There was no statistically significant difference between the two techniques for grading hyperenhancement using a 3-point scale per segment or using THS per ventricle. Furthermore, IR-trueFISP shows high sensitivity and specificity. Therefore, IR-trueFISP appears as a valuable tool for assessment of myocardial viability despite cardiac arrhythmias or patient’s inability to breath-hold.

Cappeliez, O, Baldassarre, S, Gauquier, N, Jacquy, J, Van Espen, J, Divano, L, Comparison between Single Shot Inversion Recovery trueFISP (IR-trueFISP) and Segmented Inversion Recovery Turbo FLASH (IR-TFL) for the Assessment of Myocardial Viability.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4402701.html