Black blood late gadolinium enhancement using combined T2 magnetization preparation and inversion recovery

Background Late gadolinium enhancement (LGE) imaging allows assessment of focal scar [1]. An inversion recovery based sequence is commonly used to achieve suppression of healthy myocardium signal. However, the blood pool and subendocardial scar typically have similar signal, making it difficult to distinguish subendocardial scar. Several methods have been proposed to increase the blood-scar contrast including a double inversion technique [2], and T2-prepared (T2prep) sequences [3,4]. However, all these approaches suffer from either reduced SNR or reduced scar-myocardium contrast. In this work, we propose a novel pulse sequence that uses an optimized combination of an inversion pulse and a T2prep composite pulse to simultaneously null both the healthy myocardium and blood signals, producing a black-blood LGE (BB-LGE) image without losing significant scar-myocardium contrast. We also developed a quick navigation sequence, analogous to the Look-Locker, to help determine the ideal nulling time before imaging.