Comparison of 3D Phase-Sensitive Inversion-Recovery and 2D Inversion-Recovery MRI at 3.0 T for the Assessment of Late Gadolinium Enhancement in Patients with Hypertrophic Cardiomyopathy

Abstract

To compare free-breathing three-dimensional (3D) phase-sensitive inversion recovery (PSIR) with breath-holding two-dimensional (2D) IR sequences to determine which is better for detecting and characterizing myocardial late gadolinium enhancement (LGE) in hypertrophic cardiomyopathy (HCM) patients. Thirty HCM patients clinically underwent 3.0 T cardiac magnetic resonance imaging that included 3D-PSIR and 2D-IR. The amount of LGE lesions was calculated and expressed as %LGE of the myocardial mass, and the average of the %LGE value reported by two observers was recorded as the final %LGE. We also counted the number of LGE lesions and recorded their location. The myocardium-LGE contrast, margin sharpness, artifacts, and overall image quality were graded on a 4-point grading scale (1=poor, 2=fair, 3=good, 4=excellent). The mean %LGE on 2D-IR was 24.7±0.6, 17.5±0.6, and 8.5±0.3, respectively, for the basal, mid-, and apical myocardium; the corresponding values were 24.2±0.4, 20.0±0.4, and 7.7±0.3 on 3D-PSIR (2D-IR versus 3D-PSIR, P = .87). On 2D IR and 3D-PSIR images, 13, 52, and 53, and 9, 74, and 33 LGE lesions were detected in the subendocardial, midwall, subepicardial area, respectively. The myocardium-LGE contrast and overall image quality were significantly higher on 3D-PSIR than 2D-IR images (P <.001); the sequences did not differ significantly with respect to margin sharpness and artifact. Three-dimensional PSIR sequence yields higher image contrast, better image quality, and greater detection ability for LGE lesions than 2D-IR sequence.