2022/04 - Bright-blood and dark-blood phase sensitive inversion recovery late gadolinium enhancement and T1 and T2 maps in a single free-breathing scan: an all-in-one approach [Journal Club]-Bright-blood and dark-blood Video

Bright-blood and dark-blood Video

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This study presents a new “all-in-one” cardiac MRI approach that combines quantitative T1 and T2 mapping with both bright-blood and dark-blood late gadolinium enhancement (LGE) imaging in a single free-breathing scan. The goal is to assess both diffuse myocardial disease, such as fibrosis or edema, and focal scar, such as myocardial infarction, without needing multiple separate breath-held acquisitions.<br /><br />The method builds on multi-parametric SASHA, a saturation-recovery technique that jointly measures T1 and T2. From these maps, the authors calculate synthetic phase-sensitive inversion recovery (PSIR) LGE images: bright-blood LGE from T1 alone, and dark-blood LGE from both T1 and T2. The dark-blood version is designed to suppress the blood pool, improving visibility of subendocardial scars near the ventricular cavity.<br /><br />In 14 patients with scar-related disease (chronic MI, acute MI, and myocarditis), the proposed method produced image quality comparable to conventional motion-corrected PSIR LGE. It improved blood-pool contrast in difficult subendocardial infarcts, while also generating co-registered T1 and T2 maps. Quantitatively, the calculated images showed similar or better contrast-to-noise ratios than conventional acquisitions. Phantom testing also confirmed that the T1 and T2 measurements were accurate.<br /><br />Overall, the study shows that one free-breathing acquisition can provide comprehensive, spatially aligned tissue characterization, potentially simplifying clinical workflow and reducing scan time. The authors suggest this approach could improve detection and assessment of both focal scar and diffuse myocardial abnormalities in routine CMR exams.

Keywords

cardiac MRI

T1 mapping

T2 mapping

late gadolinium enhancement

LGE imaging

free-breathing scan

myocardial fibrosis

myocardial edema

subendocardial scar

myocardial infarction