Extracellular volume MRI increases the detection of myocardial abnormalities beyond late gadolinium enhancement - initial findings

Background Late gadolinium enhancement (LGE) is excellent for identifying focal lesions in the myocardium (necrosis, fibrosis), but diffuse homogeneous abnormalities are not readily detectable. Quantitative measurement of the myocardial extracellular volume (ECV) fraction using MRI has recently been validated histologically, and implemented for parametric imaging in patients. We hypothesized that quantification of ECV using ECV imaging could detect focal lesions detected by LGE, and diffuse homogenous disturbances in the myocardial extracellular volume fraction which are not detectable by LGE. The objective of the study was to examine the diagnostic utility of ECV MRI for detecting myocardial tissue abnormalities compared to LGE.