REPAIRit: Improving Myocardial Nulling and Ghosting Artifacts of 3D Navigator‐Gated Late Gadolinium Enhancement Imaging During Arrhythmia

BACKGROUND: Cardiac 3D navigator-gated late gadolinium enhancement (LGE) imaging is important for assessment of left atrial fibrosis, but the image quality is often degraded due to arrhythmia. PURPOSE: To investigate a novel 3D LGE sequence with improved myocardial nulling and reduced ghosting artifacts during arrhythmia. STUDY TYPE: Prospective. POPULATION: Arrhythmia patients (n = 14). SEQUENCE: , REPAIRit automatically calculates the optimal inversion time (TI) based on Bloch equations. ASSESSMENT: REPAIRit LGE and the standard LGE were compared with simulations, phantom imaging, and patient studies. Patient images were assessed quantitatively, based on ghost-to-noise ratio (GNR), blood signal-to-noise ratio (SNRb), myocardial signal-to-noise ratio (SNRm), and blood-to-myocardium contrast-to-noise ratio (CNR), and qualitatively on a 4-point scale. Patients were subgrouped based on the presence of arrhythmia to assess the image quality difference. STATISTICAL TESTS: The two LGE sequences were compared by Student's t-test and Wilcoxon signed-rank test. The two patient-subgroups were compared using Welch's t-test and Wilcoxon rank-sum test. RESULTS: s (318 ± 55 msec vs. 316 ± 27 msec, P = 0.96), and significantly lower blood SNR (5.2 ± 1.8 vs. 9.2 ± 3.0, P = 0.01) and significantly worse image quality (P = 0.01 for REPAIRit and P = 0.03 for standard). DATA CONCLUSION: REPAIRit improves myocardial nulling and reduces ghosting artifacts of 3D LGE under arrhythmia. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:688-699.