Free-breathing BLADE acquisition method improves T2-weighted cardiac MR image quality compared with conventional breath-hold turbo spin-echo cartesian acquisition.

Background: Cardiac magnetic resonance (MR) has become an essential diagnostic imaging modality in cardiovascular disease. However, the insufficient image quality of traditional breath-hold (BH) T2-weighted (T2W) imaging may compromise its diagnostic accuracy.
Purpose: To assess the efficacy of the BLADE technique to reduce motion artifacts and improve the image quality.
Material and Methods: Free-breathing TSE-T2W imaging sequence with cartesian and BLADE k-space trajectory were acquired in 20 patients. Thirty patients underwent conventional BH turbo spin-echo (TSE) T2W imaging and free-breathing BLADE T2W (FB BLADE-T2W) imaging. Twenty-one patients who had a signal loss of myocardium in BH short-axis T2W turbo inversion recovery (TSE-T2W-TIR) were scanned using free-breathing BLADE T2W turbo inversion recovery (BLADE TSE-T2W-TIR). The overall image quality, blood nulling, and visualization of the heart were scored on a 5-point Likert scale. The signal loss of myocardium, incomplete fat suppression near the myocardium, and the streaking or ghosting artifacts were noted in T2W-TIR sequences additionally.
Results: The overall imaging quality, blood nulling, and the visualization of heart structure of FB BLADE-T2W imaging sequence were significantly better than those of FB T2W imaging with Cartesian k-space trajectory and BH TSE-T2W imaging sequence ( P <0.01). The FB BLADE TSE-T2W-TIR reduces the myocardium signal dropout ( P <0.05), incomplete fat suppression near myocardium ( P <0.05), and the streaking and ghosting artifacts ( P <0.05) in comparison with the BH TSE-T2W-TIR.
Conclusions: FB BLADE T2W imaging provides improved myocardial visibility, less motion sensitivity, and better image quality. It may be applied in patients who have poor breath-holding capability.