Keywords:
Cardiac, Contrast agents, MR, Contrast agent-intravenous, Imaging sequences, Tissue characterisation
Authors:
A. Cazacu; Chisinau /MD
Conclusion
Performed CE-cine imaging can be a part of imaging acquisition for clinical evaluation of patient with CMR.
Focused to shorten total examination time,
in other way this strategy can be very useful for patients in bad clinical conditions,
like significant heart failure,
where patient cooperation is progressively decreasing during scanning.
In other hand this kind of images ad new information for more accurate depiction of different pathological findings (fig.
7,
8).
Acquisition of b-SSFP cine images,
actually recommended and used for standard volumetric and functional evaluation,
after administration of gadolinium based contrast agents show modified imaging appearances (2).
This is conditioned by T2 / T1 weighted contrast of this sequences (3).
CE-cine images have increased T1 contrast of myocardium and blood pool.
In literature has published use and imaging appearances of CE-cine b-SSFP sequence on 1.5T CMR in assessment of myocardium at risk,
acute myocardial infarction,
microvascular obstruction and acute myocarditis (4-9).
This publication show image appearances of CE-cine in evaluation of chronic myocardial infarction using 3T CMR.
Acquisition of b-SSFP sequence in short time after contrast administration show significant increasing of SI in blood pool and normal myocardium.
Old myocardial infarction transmural scar at 3T MRI on cine and CE-cine can present two different patterns,
directly dependents of scar wall thickness.
On more thin myocardium image appearance look like a dark line,
comparable with chemical shift artefact ”India ink”.
More thick scar show a hyper intense pattern,
in comparison with normal myocardium,
on non-contrast and CE-cine images.
For second image pattern of myocardial scar,
after contrast administration b-SSFP sequence show significant increasing of SI.
CE-cine images seem to show this kind of appearance,
increased SI scar,
in more thin wall like non-contrast cine.
Referred to contrast ratio CE-cine images show significant increasing of absolute contrast ratio between blood,
myocardium and scar.
This have beneficial effect on the visualisation of transmural myocardial scar.
Unaltered relative contrast ratio of blood,
myocardium and scar in b-SSFP CE-cine sequences,
acquired in short time after gadolinium based contrast agents administration,
preserve the T2/T1 weighted contrast.
On complexity increased SI,
aCR and rCR enhance visualisation of pathological findings of the heart,
and can be a subject for futures studies.
In following videos is shown different image appearances of pathological findings like in Loeffler endocarditis (fig 9,
10) and myocardial hydatid cyst (11,
12),
for non-contrast cine and CE-cine.