2021/9 - Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar: a review of current techniques [Journal Club]-Webinar

Video Transcription

Video Summary

The session introduced a monthly JCMR Journal Club focused on a review paper by Dr. Robert Holtackers about dark blood late gadolinium enhancement (LGE) cardiovascular MRI. The presentation explained standard LGE imaging and why subendocardial scar can be missed when blood pool signal is too bright. It then reviewed multiple dark blood approaches designed to improve scar-to-blood contrast, including techniques based on T2 preparation, magnetization transfer, spin-lock/T1rho, consecutive inversion pulses, and methods that use standard inversion recovery or phase-sensitive inversion recovery without extra preparation.<br /><br />The talk compared black-blood and gray-blood appearances, discussed practical advantages and limitations, and highlighted issues such as scan complexity, vendor availability, field-strength dependence, and the need for more data on non-ischemic scar. Dark blood LGE was presented as especially promising for better detection of ischemic subendocardial scar and potentially improved scar quantification, though evidence remains preliminary. The Q&A addressed image display, quantification, and how these methods compare with emerging non-contrast techniques and MR fingerprinting. The session concluded that dark blood LGE is a valuable and evolving tool, with broader clinical adoption depending on further validation and easier implementation.

Keywords

dark blood LGE

cardiovascular MRI

subendocardial scar

late gadolinium enhancement

scar-to-blood contrast

inversion recovery

phase-sensitive inversion recovery

ischemic scar detection

magnetic resonance imaging