Left ventricular infarct size, peri-infarct zone, and papillary scar measurements: A comparison of high-resolution 3D and conventional 2D late gadolinium enhancement cardiac MR.
OBJECTIVE
To compare higher spatial resolution 3D late gadolinium enhancement (LGE) cardiovascular magnetic resonance (Cardiac MR) with 2D LGE in patients with prior myocardial infarction.


METHODS
Fourteen patients were studied using high spatial resolution 3D LGE (1.3 x 1.3 x 5.0 mm(3)) and conventional 2D LGE (2 x 2 x 8 mm(3)) scans. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Total infarct volume, peri-infarct volume measured in a limited slab, and papillary muscle scar volume were compared using Bland-Altman analysis. Image quality was graded.


RESULTS
3D LGE had higher scar SNR (P < 0.001), higher myocardial SNR (P = 0.001), higher papillary scar-blood CNR (P = 0.01), and greater sharpness (P = 0.01). The scar volumes agreed (14.5 +/- 8.2 for 2D, vs. 13.2 +/- 8.8 for 3D), with bias +/- 2 standard deviations (SDs) of 0.5 +/- 6.8 mL, P = 0.59 R = 0.91. The peri-infarct volumes correlated but less strongly than scar (P = 0.40, R = 0.77). For patients with more heterogeneous scar, larger peri-infarct volumes were measured by 3D (1.9 +/- 1.1 mL for 2D vs. 2.4 +/- 1.6 mL for 3D, P = 0.15, in the matched region). Papillary scar, present in 6/14 (42%) patients, was more confidently identified on 3D LGE.


CONCLUSIONS
Higher spatial resolution 3D LGE provides sharper images and higher SNR, but less myocardial nulling. Scar volumes agree well, with peri-infarct volumes correlating less well. 3D LGE may be superior in visualization of papillary muscle scar.
Beth Israel Deaconess Medical Center, Department of Medicine (Cardiovascular Division), Boston, Massachusetts, USA. dcpeters@bidmc.harvard.edu
Dana C
DC
Peters
Evan A
EA
Appelbaum
Reza
R
Nezafat
Basem
B
Dokhan
Yuchi
Y
Han
Kraig V
KV
Kissinger
Beth
B
Goddu
Warren J
WJ
Manning
D002921:Cicatrix / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D019047:Phantoms, Imaging; D018709:Statistics, Nonparametric; D018487:Ventricular Dysfunction, Left / Q000473:pathology*
D003287:Contrast Media; D019786:Gadolinium DTPA