Simultaneous myocardial and fat suppression in magnetic resonance myocardial delayed enhancement imaging

Purpose: To develop a method for fat suppression in myocardial delayed enhancement (MDE) studies that achieves effective signal intensity reduction in fat but does not perturb myocardial signal suppression. Materials and Methods: A new approach to fat suppression that uses a spectrally-selective inversion-recovery (SPEC-IR) tip-up radio frequency (RF) pulse following the conventional nonselective IR RF pulse together with a second SPEC-IR RF pulse is proposed. The tip-up pulse restores the fat longitudinal magnetization after the nonselective IR pulse and allows the fat magnetization to recover more fully toward its equilibrium value, providing for better fat suppression by the second SPEC-IR RF pulse. This new approach was validated in phantom studies and in five patients. Results: Effective fat suppression was achieved using the proposed technique with minimal impact on normal myocardial signal suppression. Mean fat suppression achieved using this approach was 67% ± 8%, as measured in the chest wall immediately opposite the heart. Conclusion: The results indicate this modular-type approach optimizes fat suppression in myocardial delayed enhancement studies but does not perturb the basic IR pulse sequence or change basic acquisition parameters.