Free-Breathing Motion-Corrected Single-Shot Phase-Sensitive Inversion Recovery Late-Gadolinium-Enhancement Imaging: A Prospective Study of Image Quality in Patients with Hypertrophic Cardiomyopathy

Figures

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  Fig. 1. Patient enrollment. HCM = hypertrophic cardiomyopathy, IQR = interquartile range, moco-ss-LGE = motion-corrected single-shot late-gadolinium-enhancement, MRI = magnetic resonance imaging

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  Fig. 2. Representative image pairs of bh-ss-LGE and moco-ss-LGE. A-D. bh-ss-LGE images (A, B) and free-breathing moco-ss-LGE (C, D) images in (A, C) a 49-year-old male patient and (B, D) a 64-year-old male patient with hypertrophic cardiomyopathy, respectively. Homogenous signal intensity of the blood and the remote myocardium, resulting in better visualization of LGE, is noted on moco-ss-LGE, compared to bh-ss-LGE. The papillary muscles and trabeculae are also more clearly demarcated from the left ventricle cavity and endocardial border on moco-ss-LGE than on bh-ss-LGE. bh-ss-LGE = breath-held single-shot LGE, LGE = late-gadolinium-enhancement, moco-ss-LGE = motion-corrected single-shot LGE

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  Fig. 3. Representative LGE imges of patients with hypertrophic cardiomyopathy with atrial fibrillation. bh-ss-LGE images (upper row) and free-breathing moco-ss-LGE images (lower row) obtained from hypertrophic cardiomyopathy patients with atrial fibrillation. The papillary muscles, trabeculae, and endocardial border are more clearly distinguished from the left ventricle cavity, and the myocardial scar (enhanced area) is more obviously demarcated from the remote myocardium on moco-ss-LGE than on bh-ss-LGE. bh-ss-LGE = breath-held single-shot late-gadolinium-enhancement, moco-ss-LGE = motion-corrected single-shot late-gadolinium-enhancement

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  Fig. 4. Comparison between the methods of LGE quantification in a 21-year-old male with asymmetric septal hypertrophic cardiomyopathy. Relative infarct size was quantified by identifying myocardial area with LGE, overlaid with yellow, using the FWHM, 6-SD, or 3-SD method. Infarct size measures on bh-ss-LGE and moco-ss-LGE were 36.1% and 38.6% with the FWHM method, 19.2% and 21.1% with the 6-SD method, and 39.1% and 39.8% with the 3-SD method, respectively. bh-ss-LGE = breath-hold single-shot LGE, FWHM = full width at half-maximum, LGE = late-gadolinium-enhancement, moco-ss-LGE = motion-corrected single-shot LGE, SD = standard deviation

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  Fig. 5. Bland-Altman plots illustrate good agreement across the LGE size spectrum between bh-ss-LGE and free-breathing moco-ss-LGE images. Solid and dotted lines indicate the mean difference and ± 1.96 SD of the differences, respectively. bh-ss-LGE = breath-hold single-shot LGE, FWHM = full width at half-maximum, LGE = late-gadolinium-enhancement, moco-ss-LGE = motion-corrected single-shot LGE, SD = standard deviation