PT  - JOURNAL ARTICLE
AU  - Rohin Francis
AU  - Peter Kellman
AU  - Tushar Kotecha
AU  - Ana Martinez-Naharro
AU  - Daniel S Knight
AU  - Roby D Rakhit
AU  - James C Moon
AU  - Derek J Hausenloy
AU  - Marianna Fontana
TI  - 6 A new way to image infarction: dark blood late gadolinium enhancement vs conventional imaging for the detection of scar
AID  - 10.1136/heartjnl-2018-BCIS.6
DP  - 2018 Jan 01
TA  - Heart
PG  - A4--A4
VI  - 104
IP  - Suppl 1
4099  - http://heart.bmj.com/content/104/Suppl_1/A4.1.short
4100  - http://heart.bmj.com/content/104/Suppl_1/A4.1.full
SO  - Heart2018 Jan 01; 104
AB  - Background Conventional bright blood late gadolinium enhancement (LGE) imaging offers excellent contrast between areas of infarction and normal myocardium. However, contrast between subendocardial scar and blood is frequently poor. Dark blood LGE (DB LGE) employs an inversion recovery T2 preparation to suppress the blood pool, increasing contrast between the endocardium and blood. This study compares the diagnostic utility of a novel DB LGE sequence to standard bright blood LGE.Methods 172 patients were scanned. A full left ventricle short axis stack was performed using both techniques. Two observers scored presence and extent of LGE, along with how confident they were in their diagnoses, for all patients.Results 2752 LV segments were analysed. DB LGE found 41.5% more segments that showed LGE in comparison to bright blood (figure 1). DB imaging also allowed observers to be more confident when diagnosing LGE, assigning high confidence to 84.9% of DB LGE segments but only 62.1% when using bright blood. DB LGE identified missed myocardial infarctions in 18 patients with negative bright blood scans.Abstract 6 Figure 1 Four slices through the LV of a patient with a large anterior myocardial infarction. Top row – conventional bright blood imaging, bottom row – novel dark blood imagingConclusions DB LGE imaging significantly increases LGE detection compared to standard bright blood imaging. It also increases observer confidence, particularly for subendocardial LGE. This may have important clinical implications for troponin-positive events with unobstructed coronaries.