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Updated: Jan 8, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Comprehensive three-dimensional free-breathing magnetic resonance imaging for simultaneous myocardial viability and
Dongyue Si1, Simon J Littlewood1, Michael G Crabb1
1School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
Insights
This study introduces the GB-BOOST sequence for simultaneous 3D cardiovascular magnetic resonance imaging of myocardial scar and coronary arteries. This novel approach offers comparable image quality to separate scans, improving efficiency in cardiac diagnostics.
Area of Science:
- Cardiovascular Magnetic Resonance Imaging
- Medical Imaging Techniques
- Cardiac Diagnostics
Background:
- Cardiovascular magnetic resonance (CMR) enables non-invasive assessment of cardiac diseases using techniques like late gadolinium enhancement (LGE) for tissue characterization and coronary magnetic resonance angiography (CMRA) for anatomical imaging.
- Current clinical practice often acquires LGE and CMRA separately, leading to disparities in spatial resolution and slice positioning.
- This limitation hinders comprehensive, simultaneous cardiac assessment.
Purpose of the Study:
- To develop and validate a novel free-breathing, simultaneous 3D gray-blood phase-sensitive inversion recovery (PSIR) LGE and 3D CMRA imaging sequence.
- To introduce the Gray-Blood and Bright-blOOd phase SensiTive inversion recovery (GB-BOOST) sequence as a potential one-stop solution for cardiac imaging.
Main Methods:
- The GB-BOOST sequence interleaves two 3D volumes using inversion recovery and T2 preparation pulses for PSIR and CMRA, respectively.
- Respiratory motion is managed using 2D image navigators (iNAV) for free-breathing acquisition with 100% respiratory efficiency.
- The framework supports Dixon gradient echo (GRE) and balanced steady-state free precession (bSSFP) sequences, validated in 23 patients on 3T and 1.5T scanners.
Main Results:
- GB-BOOST successfully imaged all 23 patients, acquiring co-registered 3D PSIR and CMRA images with 1.2 mm³ resolution in 9.4±1.3 minutes.
- 3D PSIR via GB-BOOST demonstrated comparable scar detection performance to clinical 2D PSIR, with no significant differences in scar-to-blood, scar-to-myocardium, or blood-to-myocardium contrast.
- 3D T2prep GB-BOOST provided image quality and quantitative vessel metrics comparable to standard 3D CMRA sequences.
Conclusions:
- The GB-BOOST sequence effectively achieves simultaneous, co-registered 3D whole-heart gray-blood PSIR and CMRA in a single scan.
- The technique offers image contrast and quality on par with separately acquired LGE and CMRA images.
- GB-BOOST represents a promising advancement for efficient and comprehensive cardiac magnetic resonance imaging.
Background:
Cardiovascular magnetic resonance is promising for non-invasive assessment of various cardiac diseases with the ability to provide multi-contrast images, including late gadolinium enhancement (LGE) for myocardial tissue characterization and coronary magnetic resonance angiography (CMRA) for anatomical imaging. However, LGE and CMRA are usually acquired separately in clinical routine with unmatched spatial resolution and slice positions. In this proof of concept study, we aim to achieve a one-stop imaging of 3D gray-blood phase-sensitive inversion recovery (PSIR) LGE and 3D CMRA by proposing a free-breathing simultaneous Gray-Blood and Bright-blOOd phase SensiTive inversion recovery (GB-BOOST) sequence.
Methods:
The proposed research sequence acquires two interleaved 3D volumes with inversion recovery and T2 preparation pulses to obtain gray-blood PSIR and CMRA, respectively. Two-dimensional image navigator (iNAV) is performed before the acquisition of each volume to detect respiratory motion, enabling free-breathing acquisition with 100% respiratory scan efficiency. The GB-BOOST framework is compatible with both Dixon gradient echo (GRE) and balanced steady-state free precession (bSSFP) sequences for the application at 3T and 1.5T. In-vivo validation experiments included in total 23 patients for GB-BOOST, which were performed on either a 3T or a 1.5T clinical scanner. The performance of the proposed sequence was compared with clinical 2D gray-blood PSIR and free-breathing 3D CMRA.
Results:
GB-BOOST was successfully performed on all 23 patients and was able to efficiently acquire intrinsically co-registered 3D PSIR and CMRA images with 1.2 mm3 resolution in 9.4±1.3 min. Compared with 2D gray-blood PSIR, 3D PSIR GB-BOOST had comparable scar area detection performance without significant differences in image contrast of scar-to-blood (0.42±0.40 vs. 0.30±0.43, p = 0.38), scar-to-myocardium (1.09±0.27 vs. 1.02±0.32, p = 0.30), and blood-to-myocardium (0.67±0.19 vs. 0.72±0.23, p = 0.56). Compared with single-contrast 3D CMRA sequence, 3D T2prep GB-BOOST showed comparable image quality and quantitative vessel metrics of coronary arteries.
Conclusion:
The proposed GB-BOOST sequence can achieve simultaneous co-registered 3D whole-heart gray-blood PSIR and CMRA in a single scan with image contrast and image quality comparable with separately acquired images.
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