Abstract
Background Breath-hold (BH) segmented TURBO FLASH (TFL) is currently used as the gold standard technique to evaluate delayed enhancement (DE) of the myocardium, typically with a phase sensitive inversion recovery (PSIR) approach (1). However, many patients are unable to perform adequate breath-holding resulting in poor image quality and limited diagnostic yield. Free breathing (FB) single shot steady state free precession (SSFP) is used as an alternative approach however respiratory motion artifact with resultant blurring may affect visualization of smaller myocardial scars. FB motion corrected (MOCO) single shot SSFP with averaging (2) has been shown to be equal or superior in detecting myocardial infarction (3), particularly in vulnerable patients. For FB MOCO sequences to replace current BH techniques in the detection of DE, they must be sensitive to the detection of both ischemic and non-ischemic patterns of delayed enhancement.
Highlights
Breath-hold (BH) segmented TURBO FLASH (TFL) is currently used as the gold standard technique to evaluate delayed enhancement (DE) of the myocardium, typically with a phase sensitive inversion recovery (PSIR) approach (1)
Of the 39 DE segments identified on Free breathing (FB) motion corrected (MOCO), 2 were not identified on FB steady state free precession (SSFP) and 4 were not identified on BH TFL. 1 DE segment was identified on each of FB SSFP and BH TFL but neither other sequence
All patients with DE on either FB SSFP or BH TFL were identified on FB MOCO
Summary
Breath-hold (BH) segmented TURBO FLASH (TFL) is currently used as the gold standard technique to evaluate delayed enhancement (DE) of the myocardium, typically with a phase sensitive inversion recovery (PSIR) approach (1). Many patients are unable to perform adequate breath-holding resulting in poor image quality and limited diagnostic yield. Free breathing (FB) single shot steady state free precession (SSFP) is used as an alternative approach respiratory motion artifact with resultant blurring may affect visualization of smaller myocardial scars. FB motion corrected (MOCO) single shot SSFP with averaging (2) has been shown to be equal or superior in detecting myocardial infarction (3), in vulnerable patients. For FB MOCO sequences to replace current BH techniques in the detection of DE, they must be sensitive to the detection of both ischemic and non-ischemic patterns of delayed enhancement
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