Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar: a review of current techniques.

Abstract

For almost 20 years, late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been thereference standard for the non-invasive assessment of myocardial viability. Since the blood pool often appears equallybright as the enhanced scar regions, detection of subendocardial scar patterns can be challenging. Various novelLGE methods have been proposed that null or suppress the blood signal by employing additional magnetizationpreparation mechanisms. This review aims to provide a comprehensive overview of these dark-blood LGE methods,discussing the magnetization preparation schemes and fndings in phantom, preclinical, and clinical studies. Finally,conclusions on the current evidence and limitations are drawn and new avenues for future research are discussed.Dark-blood LGE methods are a promising new tool for non-invasive assessment of myocardial viability. For a mainstream adoption of dark-blood LGE, however, clinical availability and ease of use are crucial.