Improved MRI Assessment of the Left Atrial Appendage Using Delayed Enhancement Imaging as Compared to Black Blood Fast Spin Echo Imaging

Thanh D. Nguyen¹, Matthew D. Cham¹, Jason Chinitz², Pascal Spincemaille¹, James K. Min^1,2, Bruce B. Lerman², Martin R. Prince¹, Yi Wang¹, Jonathan W. Weinsaft^1,2

Left atrial appendage (LAA) imaging is important as this is a primary site for cardiac thrombus which causes embolic events. Delayed enhancement MRI (DE-MRI) has recently been shown to accurately evaluate left ventricular thrombus, but its utility for LAA imaging is not known. In this study, LAA imaging by DE-MRI and black blood fast spin echo (BB-FSE) were compared to a reference of cine SSFP. Single shot and segmented DE-MRI were found to provide similar measurements of LAA size and image contrast compared to SSFP. BB-FSE imaging suffers from severe intraluminal signal artifacts, leading to inaccurate measurements.