title: Multiecho dixon fat and water separation method for detecting fibrofatty infiltration in the myocardium.
abstract: Conventional approaches for fat and water discrimination based on chemical-shift fat suppression have reduced ability to characterize fatty infiltration due to poor contrast of microscopic fat. The multiecho Dixon approach to water and fat separation has advantages over chemical-shift fat suppression: 1) water and fat images can be acquired in a single breathhold, avoiding misregistration; 2) fat has positive contrast; 3) the method is compatible with precontrast and late-enhancement imaging, 4) less susceptible to partial-volume effects, and 5) robust in the presence of background field variation; and 6) for the bandwidth implemented, chemical-shift artifact is decreased. The proposed technique was applied successfully in all 28 patients studied. This included 10 studies with indication of coronary artery disease (CAD), of which four cases with chronic myocardial infarction (MI) exhibited fatty infiltration; 13 studies to rule out arrhythmogenic right ventricular cardiomyopathy (ARVC), of which there were three cases with fibrofatty infiltration and two confirmed with ARVC; and five cases of cardiac masses (two lipomas). The precontrast contrast-to-noise ratio (CNR) of intramyocardial fat was greatly improved, by 240% relative to conventional fat suppression. For the parameters implemented, the signal-to-noise ratio (SNR) was decreased by 30% relative to conventional late enhancement. The multiecho Dixon method for fat and water separation provides a sensitive means of detecting intramyocardial fat with positive signal contrast.
authors.affiliation: Laboratory of Cardiac Energetics, National Heart, Lung and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland 20892-1061, USA. kellman@nih.gov
authors.forename: Peter
authors.initials: P
authors.lastname: Kellman
authors.forename: Diego
authors.initials: D
authors.lastname: Hernando
authors.forename: Saurabh
authors.initials: S
authors.lastname: Shah
authors.forename: Sven
authors.initials: S
authors.lastname: Zuehlsdorff
authors.forename: Renate
authors.initials: R
authors.lastname: Jerecic
authors.forename: Christine
authors.initials: C
authors.lastname: Mancini
authors.forename: Zhi-Pei
authors.initials: ZP
authors.lastname: Liang
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Arai
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000465:Algorithms; D003324:Coronary Artery Disease / Q000473:pathology*; D017352:Echo-Planar Imaging / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D017202:Myocardial Ischemia / Q000473:pathology*; D009206:Myocardium / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D014867:Water
chemical_list: D014867:Water