Usefulness of india ink artifact in steady-state free precession pulse sequences for detection and quantification of intramyocardial fat

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Abstract

Purpose:

In steady state free precession (SSFP) images acquired with a repetition time/echo time (TR/TE) ≈ 2, fat is surrounded by a black boundary, called “India Ink” artifact. Indian Ink artifact may improve detection of intramyocardial fat. Aims of this study were: (i) to assess the accuracy of SSFP technique for the detection of fat metaplasia in remote myocardial infarction (RMI); (ii) to evaluate the inter- and intraobserver reproducibility for the quantification of intramyocardial fat using SSFP and fast spin echo/short TI inversion recovery (FSE/STIR) techniques.

Materials and Methods:

A total of 200 patients (age 64 ± 10 years) with RMI (>1000 days) underwent MRI using a 1.5 Tesla (T) scanner. SSFP images (with a TR/TE ≈2), FSE and STIR images were acquired in short and long axis views. Fat was detected in FSE/STIR and SSFP images and its extent manually measured. The inter- and intraobserver agreement for the quantification of fat metaplasia using both the SSFP image and the FSE images was evaluated.

Results:

Left ventricle intramyocardial fat was detected in SSFP images of 95 patients (47.5%) and in FSE/STIR images of 84 patients (42%). A very good agreement was found using the SSFP technique between investigators.

Conclusion:

SSFP sequence with TR/TE=2 is a valuable technique for identifying and quantifying the presence of fat tissue within the left ventricle myocardium in RMI. J. Magn. Reson. Imaging 2014;40:126–132. © 2013 Wiley Periodicals, Inc.

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