title: Value of black blood T2* cardiovascular magnetic resonance.
abstract: OBJECTIVE
  To assess whether black blood T2* cardiovascular magnetic resonance is superior to conventional white blood imaging of cardiac iron in patients with thalassaemia major (TM).
  
  
  METHODS
  We performed both conventional white blood and black blood T2* CMR sequences in 100 TM patients to determine intra and inter-observer variability and presence of artefacts. In 23 patients, 2 separate studies of both techniques were performed to assess interstudy reproducibility.
  
  
  RESULTS
  Cardiac T2* values ranged from 4.5 to 43.8 ms. The mean T2* values were not different between black blood and white blood acquisitions (20.5 vs 21.6 ms, p=0.26). Compared with the conventional white blood diastolic acquisition, the coefficient of variance of the black blood CMR technique was superior for intra-observer reproducibility (1.47% vs 4.23%, p<0.001), inter-observer reproducibility (2.54% vs 4.50%, p<0.001) and inter-study reproducibility (4.07% vs 8.42%, p=0.001). Assessment of artefacts showed a superior score for black blood vs white blood scans (4.57 vs 4.25; p<0.001).
  
  
  CONCLUSIONS
  Black blood T2* CMR has superior reproducibility and reduced imaging artefacts for the assessment of cardiac iron, in comparison with the conventional white blood technique, which make it the preferred technique for clinical practice.
authors.affiliation: CMR Unit, Royal Brompton Hospital, and National Heart & Lung Institute, Imperial College London, Sydney Street, London SW3 6NP, UK.
authors.forename: Gillian C
authors.initials: GC
authors.lastname: Smith
authors.forename: John Paul
authors.initials: JP
authors.lastname: Carpenter
authors.forename: Taigang
authors.initials: T
authors.lastname: He
authors.forename: Mohammed H
authors.initials: MH
authors.lastname: Alam
authors.forename: David N
authors.initials: DN
authors.lastname: Firmin
authors.forename: Dudley J
authors.initials: DJ
authors.lastname: Pennell
mesh_terms: D000293:Adolescent; D000328:Adult; D016477:Artifacts; D002648:Child; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006486:Hemosiderosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007501:Iron / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D065227:Transfusion Reaction; D055815:Young Adult; D017086:beta-Thalassemia / Q000097:blood / Q000628:therapy*
chemical_list: D007501:Iron