Research

Late Gadolinium Enhancement of the right ventricular myocardium: Is it really different from the left ?

Lars Grosse-Wortmann^1,2,3 , Christopher K Macgowan^4,5 , Logi Vidarsson¹ and Shi-Joon Yoo^1,2

¹Section of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, The University of Toronto, Toronto, Canada

²Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, The University of Toronto, Toronto, Canada

³Department of Pediatric Cardiology, RWTH University of Aachen, Germany

⁴Department of Medical Biophysics, The Hospital for Sick Children, The University of Toronto, Toronto, Canada

⁵Department of Medical Imaging, The Hospital for Sick Children, The University of Toronto, Toronto, Canada

author email corresponding author email

Journal of Cardiovascular Magnetic Resonance 2008, 10:20doi:10.1186/1532-429X-10-20

Published:	8 May 2008

Abstract

It has been suggested that, in late gadolinium enhancement, the signal of right ventricular myocardium is nulled at a shorter inversion time than the left. While we initially made the same observation, we believe that the difference is not real, but results from artifacts.

We present 7 cases as well as computer simulations to describe the nature of these artifacts and explain how they can create the impression of different inversion times for the right and left ventricle. At inversion times that are shorter than ideal for the myocardium a black rim can be seen at the border of the myocardium with blood on the inside and with fat on the outside. This is most likely a partial volume effect. The thin myocardium of the right ventricle is sandwiched between these black rims and, at a low spatial resolution, is no longer visible. In this case, the adjacent black rims may then be misinterpreted as myocardium. While black rims also occur on the left side, the myocardium is thicker and remains discernable as a separate layer. As a consequence, the optimal inversion time for the right ventricle only appears different from that for the left. In fact, in the presence of hypertrophy of the right ventricle or during systolic wall thickening we did not find a difference in inversion times between the left and right ventricle. We conclude that sufficient spatial resolution is important for adequate late gadolinium enhancement of the right ventricle.