Armin Michael Huber MD, Presenter: Nothing to Disclose

Marcus R. Settles PhD, Abstract Co-Author: Nothing to Disclose

Ken Herrmann, Abstract Co-Author: Nothing to Disclose

Ambros Johannes Beer MD, Abstract Co-Author: Research Funding, Pieris AG, Munich Germany

Moritz Wildgruber MD, PhD, Abstract Co-Author: Nothing to Disclose

Ernst J. Rummeny MD, Abstract Co-Author: Nothing to Disclose

To investigate, if myocardial infarction with a double inversion recovery (IR) gradient echo (GRE) sequence can improve suppression of blood signal in the left ventricular cavity in delayed enhancement imaging.

16 patients with myocardial infarction were examined on a 1.5 Tesla system (Philips, Achieva). Ten minutes after contrast media application (0.2 mmol/kg gadopentetate dimeglumine) a state-of-the art delayed enhancement imaging was performed using a segmented 2D IR GRE sequence (TR/TE/bandwidth: 1.2 msec, 3.6 msec, 384 Hz/Px) which served as reference method (1, 2). A segmented double IR GRE sequence (TR/TE/bandwidth: 1.2 msec, 3.6 msec, 384 Hz/Px) was used to achieve improved suppression of signal in the left ventricular cavity. The optimal inversion time for the standard IR GRE sequence was determined with a look locker sequence. The two inversion times for the double IR GRE sequence were calculated with an inhouse-written software. Results of phantom studies and the inversion times of myocardial infarction and normal myocardium, which were determined with the look locker images, allowed for individual calculation of the 2 inversion times. Contrast-to-noise ratios of myocardial infarction in relation to normal myocardium (CNRinf-myo) and to the left ventricular cavity (CNRinf-LVC) were calculated.

The mean values for CNRinf-myo and CNRinf-LVC for the reference technique, IR GE were 14.2 and 5.8 and for the double IR GRE 13.2 and 8.8. No significant difference was found for the CNRinf-myo (n.s., p > 0.05). The ratio of CNRinf-LVC and CNRinf—myo was 0.66 for the double IR GRE and 0.41 for the reference technique.

A double IR GRE sequence improves the ratio of CNR of infarction and left ventricular cavity compared to a reference technique.

With better differentiation of small subendocardial infarctions from the left ventricular cavity, small myocardial infarctions may be detected with higher sensitivity compared to standard techniques.

Huber, A, Settles, M, Herrmann, K, Beer, A, Wildgruber, M, Rummeny, E, Double Inversion Recovery “Black-Blood” Gradient Echo for Detection of Myocardial Infarction.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013937.html