Dark-blood late gadolinium enhancement cardiovascular magnetic resonance for improved detection of subendocardial scar: a review of current techniques

Robert J. Holtackers*, Caroline M. Van De Heyning, Amedeo Chiribiri, Joachim E. Wildberger, Rene M. Botnar, M. Eline Kooi

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

8 Citations (Web of Science)


For almost 20 years, late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) has been the reference standard for the non-invasive assessment of myocardial viability. Since the blood pool often appears equally bright as the enhanced scar regions, detection of subendocardial scar patterns can be challenging. Various novel LGE methods have been proposed that null or suppress the blood signal by employing additional magnetization preparation mechanisms. This review aims to provide a comprehensive overview of these dark-blood LGE methods, discussing the magnetization preparation schemes and findings in phantom, preclinical, and clinical studies. Finally, conclusions on the current evidence and limitations are drawn and new avenues for future research are discussed. Dark-blood LGE methods are a promising new tool for non-invasive assessment of myocardial viability. For a mainstream adoption of dark-blood LGE, however, clinical availability and ease of use are crucial.

Original languageEnglish
Article number96
Number of pages18
JournalJournal of Cardiovascular Magnetic Resonance
Issue number1
Publication statusPublished - 22 Jul 2021


  • Cardiovascular diseases
  • Myocardial infarction
  • Magnetic resonance imaging
  • Late gadolinium enhancement
  • Myocardial scar
  • MRI

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