High-Resolution Late Gadolinium Enhancement Magnetic Resonance for the Diagnosis of Myocardial Infarction With Nonobstructed Coronary Arteries

Clinical application of free-breathing 3D whole heart late gadolinium enhancement cardiovascular magnetic resonance with high isotropic spatial resolution using Compressed SENSE

“…As previously shown when comparing free-breathing to breath-hold LGE, readers detected more smaller hyperenhanced lesions using free-breathing LGE, mostly because of its contiguous, high-resolution acquisition in through-plane direction and because breath-hold LGE suffers from partial volume effect due to its lower voxel size [22][23][24]39]. Although a voxel partially contains spins with high signal intensity, an overall elimination of high signal intensity of the voxel may occur if it is also occupied by spins with low signal intensity [39].…”

“…However, long acquisition time remains one of the main limitations for the majority of techniques. In this context, Andreu et al reported scan times of 16.4 ± 7.2 min (for 1.4 mm 3 reconstructed resolution) [25], Bizino et al of 09:34 ± 03:04 min (0.9 mm 3 reconstructed resolution) [26], and Lintingre et al of 8-10 min (1.25 × 1.25 × 2.5 mm acquired resolution) [24]. Bratis et al introduced respiratory self-navigation for whole heart LGE in 03:52 min with 2.0 mm 3 acquired and 1.0 mm 3 reconstructed resolution [18] whereas Kino et al demonstrated the use of phase-sensitive inversionrecovery (PSIR) for free-breathing LGE with 2.0 mm 3 acquired resolution in 06:10 ± 02:56 min [23].…”

“…Further, they are hampered by long breath-hold duration, hence widely unsuitable for clinical routine [15,16]. When applying different techniques for navigator-gating such as respiratory bellows signal [17], respiratory self-navigation [18][19][20], and diaphragmatic pencil-beam navigation [3] to reduce respiratory artifacts, 3D LGE can be performed during free-breathing enabling 3D assessment of the whole heart with higher spatial resolution [21][22][23][24]. Nevertheless, free-breathing 3D LGE techniques suffer from long imaging time, especially when aiming to provide readouts with submillimetre high isotropic spatial resolution [24][25][26].…”

“…When applying different techniques for navigator-gating such as respiratory bellows signal [17], respiratory self-navigation [18][19][20], and diaphragmatic pencil-beam navigation [3] to reduce respiratory artifacts, 3D LGE can be performed during free-breathing enabling 3D assessment of the whole heart with higher spatial resolution [21][22][23][24]. Nevertheless, free-breathing 3D LGE techniques suffer from long imaging time, especially when aiming to provide readouts with submillimetre high isotropic spatial resolution [24][25][26]. Consequently, drawbacks like susceptibility to varying heart rate and respiratory motion as well as changing accumulation of contrast agent in injured myocardium with inadequate nulling of healthy tissue question their feasibility and usefulness in clinical routine [27,28].…”

Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes

“…Further, we have not performed biopsies, and thus we can only speculate on the aetiology of the lesions based on statistical associations. In this study we did not perform high resolution LGE or feature tracking, both newer and emerging techniques that could possibly have helped phenotyping our cohort even more [ 33 , 34 ]. However, as LGE of the non-ischemic type was generally smaller than the ischemic lesions we speculate that there would not have been detectable regional strain differences in the none-ischemic lesion areas.…”