Diagnostic Accuracy of Single-shot 2-Dimensional Multisegment Late Gadolinium Enhancement in Ischemic and Nonischemic Cardiomyopathy

Purpose:The aim of this study was to assess the reliability of single-shot 2-dimensional multislice late gadolinium enhancement (2D-MSLGE) compared with gold standard single-slice 2D inversion recovery segmented gradient echo (2D-SSLGE).Materials and Methods:Sixty-seven patients prospectively underwent clinically indicated cardiac magnetic resonance (CMR) imaging and were enrolled. The image quality was assessed using a 4-point scale. Segments positive for LGE were classified as ischemic or nonischemic for 2D-MSLGE and 2D-SSLGE. Interobserver and intraobserver variability was assessed for both sequences by 2 readers. The endpoints were as follows: (a) detection of myocardial segments involved by LGE and (b) classification of LGE as ischemic and nonischemic pattern. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy value were calculated for the 2 endpoints.Results:2D-MSLGE and 2D-SSLGE were successfully performed in all patients with comparable image quality (1.56±0.59 vs. 1.54±0.58, P=0.84). For the overall population, 2D-MSLGE correctly identified 1093 of 1139 myocardial segments positive for LGE (96%; 95% confidence interval [CI]: 95%-97%), as compared with 2D-SSLGE. Similarly, 2D-MSLGE correctly identified 1128 of 1139 (99%; 95% CI: 98%-99%) and 1108 of 1139 (97%; 95% CI: 96%-98%) of nonischemic and ischemic LGE patterns.Interobserver and intraobserver variability for quantification of LGE using 2D-MSLGE was 0.98 and 0.99, respectively. The acquisition time was shorter for 2D-MSLGE as compared with 2D-SSLGE (2.0±0.5 vs. 6.0±2.0 min, P: 0.01).Conclusions:As compared with 2D-SSLGE, 2D-MSLGE is a reliable tool in both ischemic and nonischemic cardiac disease; it is associated with shorter scan times without the need for prolonged breath holding and may be beneficial for those with dysrhythmia.