Eugene G. Kholmovski1,2, Sathya Vijayakumar1,2,
Christopher J. McGann2,3, Joshua Blauer2,4, Ravi Ranjan2,3,
Gaston Vergara2,3, Gene Payne1,2, Nelly Volland1,2,
Rob MacLeod2,4, Nassir F. Marrouche2,3
1UCAIR, Department of
Radiology, University of Utah, Salt Lake City, UT, United States; 2CARMA
Center, University of Utah, Salt Lake City, UT, United States; 3Department
of Cardiology, University of Utah, Salt Lake City, UT, United States; 4SCI
Institute, University of Utah, Salt Lake City, UT, United States
Serial LGE-MRI detects two distinct enhancement patterns in ablated regions of atrial wall. Lesion core identified by no-reflow in early LGE and enhancement in very late LGE has very slow contrast dynamics, whereas the regions around the lesion core (edema) have relatively fast contrast dynamics. This obvious difference in contrast dynamics can be exploited to discriminate permanent injury from transient ones. High correlation between lesion measurements made ex-vivo and the original no-reflow or very delayed enhancement shows that LGE-MRI acquired at the right time after contrast injection can be a reliable predictor of permanent scar.