1. Segmented IR GRE imaging during diastolic rest period
  2. 4CH, 3CH, 2CH, SA images
  3. In-plane resolution : <2mm
  4. EGE: image 1-3min after contrast, TI >400ms
  5. LGE: ≥10min after Gd injection (0.1 – 0.2mmol /kg))
    • The delay may be shorter if lower Gd doses are used
    • The delay may be increased in a low output state
  6. TI set to null normal myocardium:
    • TI scout or Look Locker sequence
    • Phase-sensitive sequence with fixed TI as alternative
  7. Readout:
    • Usually every other heartbeat
    • Every heartbeat in the setting of bradycardia
    • Every third heartbeat in the setting of tachycardia
Tips and Tricks
  1. Scan in mid- or late-diastole to minimize motion artefacts
  2. Use saturation bands across the spinal column and the anterior chest wall to reduce ghosting artefacts
  3. Late enhancement on images:
    • Use “Phase Swap” (changing the phase encoding direction) to confirm pathology/detect artefact
    • Always consider a different plane cross-cutting through the enhanced area
  4. Increase TI times by 10 – 15ms every couple of minutes, because the correct TI for “nulling” of normal myocardium slowly changes over time
  5. To reduce breath-hold times use acceleration techniques
  6. Acquiring the images during every second or third heartbeat can help if there are problems with arrhythmia
  7. Consider infiltrative disease (amyloidosis) if normal myocardium is hard to null despite correct technique