(LE) Myocardial late enhancement in contrast enhanced cardiac MRI has the ability to precisely delineate myocardial scar associated with coronary artery disease. Viability imaging implies evaluating infarcted myocardium to see whether there is enough viable tissue available for revascularization. The reversal of myocardial dysfunction is particularly relevant in patients with depressed ventricular function because revascularization improves long-term survival. In comparison to SPECT and PET imaging, myocardial late enhancement MRI demonstrates areas of delayed enhancement exactly in correlation with the infarcted region.
Viability on cardiac MRI (CMR) is based on the fact that all infarcts enhance vividly 10-15 minutes after the administration of intravenous paramagnetic contrast agents. This enhancement represents the accumulation of gadolinium in the extracellular space, due to the loss of membrane integrity in the infarcted tissue. This phenomenon of delayed hyperenhancement has been proven to correlate with the actual extent of the infarct.
MRI myocardial late enhancement can quantify the size, location and transmural extent of the infarct. If the transmural extent of the infarct (region of enhancement on MRI) is less than 50% of the wall thickness, there will be improved contractility in that segment following revascularization. In areas of hypokinesia, if there is a rim of "black" or non-infarcted myocardium that is not contracting well, it indicates the presence of hibernating myocardium, which is likely to improve after revascularization of the artery supplying that particular territory.
The total duration of a myocardial late enhancement MR imaging protocol for viability is approximately 30 minutes, including scout images, first-pass images, cine images in two planes, and delayed myocardial enhancement images. In order to assess viable myocardium, the gadolinium contrast agent is injected at a dose of 0.15 to 0.2 mmol/kg. After about 10 minutes, short axis and long axis views (see cardiac axes) of the heart are obtained using an inversion prepared ECG gated gradient echo sequence. The inversion pulse is adjusted to suppress normal myocardium. Areas of nonviable myocardium retain extremely high signal intensity, black areas show normal tissue.

For Ultrasound Imaging (USI) see Myocardial Contrast Echocardiography at Medical-Ultrasound-Imaging.com.

(PE) The partial echo technique (also called fractional echo) is used to shorten the minimum echo time. By the acquisition of only a part of k-space data this technique benefits (like all partial Fourier techniques) from the complex conjugate symmetry between the k-space halves (this is called Hermitian symmetry).
The dephasing gradient in the frequency direction is reduced, and the duration of the readout gradient and the data acquisition window are shortened. Partial echo gives a better SNR at a given TE when a smaller FOV or thinner slices are selected, allows a longer sampling time, and a larger water fat shift (WFS, see also bandwidth) due to a lower gradient amplitude. The resolution is not affected. This is often used in gradient echo sequences (e.g. FLASH, Contrast Enhanced Magnetic Resonance Angiography) to reduce the echo time and yields a lower gradient moment. The disadvantage of using a partial echo can be a lower SNR, although this may be partly offset by the reduced echo time.
Also called Fractional Echo, Read Conjugate Symmetry, Single Side View.

See also Partial Fourier Technique and acronyms for 'partial echo' from different manufacturers.

(PSIF) A heavily T2* weighted contrast enhanced gradient echo (mirrored FISP) technique. Because TE is relatively long, there are much flow artifacts and less signal to noise. In normal gradient echo techniques a FID-signal results after the RF pulses. This FID is rephased very fast and just before the next FID follows a spin echo signal. The SE is spoiled in FLASH sequences, but with PSIF sequences, only the SE is measured, not the FID.

(PWI - Perfusion Weighted Imaging) Perfusion MRI techniques (e.g. PRESTO - Principles of Echo Shifting using a Train of Observations) are sensitive to microscopic levels of blood flow. Contrast enhanced relative cerebral blood volume (rCBV) is the most used perfusion imaging. Both, the ready availability and the T2* susceptibility effects of gadolinium, rather than the T1 shortening effects make gadolinium a suitable agent for use in perfusion imaging. Susceptibility here refers to the loss of MR signal, most marked on T2* (gradient echo)-weighted and T2 (spin echo)-weighted sequences, caused by the magnetic field-distorting effects of paramagnetic substances.
T2* perfusion uses dynamic sequences based on multi or single shot techniques. The T2* (T2) MRI signal drop within or across a brain region is caused by spin dephasing during the rapid passage of contrast agent through the capillary bed. The signal decrease is used to compute the relative perfusion to that region. The bolus through the tissue is only a few seconds, high temporal resolution imaging is required to obtain sequential images during the wash in and wash out of the contrast material and therefore, resolve the first pass of the tracer. Due to the high temporal resolution, processing and calculation of hemodynamic maps are available (including mean transit time (MTT), time to peak (TTP), time of arrival (T0), negative integral (N1) and index.
An important neuroradiological indication for MRI is the evaluation of incipient or acute stroke via perfusion and diffusion imaging. Diffusion imaging can demonstrate the central effect of a stroke on the brain, whereas perfusion imaging visualizes the larger 'second ring' delineating blood flow and blood volume. Qualitative and in some instances quantitative (e.g. quantitative imaging of perfusion using a single subtraction) maps of regional organ perfusion can thus be obtained.
Echo planar and potentially echo volume techniques together with appropriate computing power offer real time images of dynamic variations in water characteristics reflecting perfusion, diffusion, oxygenation (see also Oxygen Mapping) and flow.
Another type of perfusion MR imaging allows the evaluation of myocardial ischemia during pharmacologic stress. After e.g., adenosine infusion, multiple short axis views (see cardiac axes) of the heart are obtained during the administration of gadolinium contrast. Ischemic areas show up as areas of delayed and diminished enhancement. The MRI stress perfusion has been shown to be more accurate than nuclear SPECT exams. Myocardial late enhancement and stress perfusion imaging can also be performed during the same cardiac MRI examination.

(SENSE) A MRI technique for relevant scan time reduction. The spatial information related to the coils of a receiver array are utilized for reducing conventional Fourier encoding. In principle, SENSE can be applied to any imaging sequence and k-space trajectories. However, it is particularly feasible for Cartesian sampling schemes. In 2D Fourier imaging with common Cartesian sampling of k-space sensitivity encoding by means of a receiver array enables to reduce the number of Fourier encoding steps.
SENSE reconstruction without artifacts relies on accurate knowledge of the individual coil sensitivities. For sensitivity assessment, low-resolution, fully Fourier-encoded reference images are required, obtained with each array element and with a body coil.
The major negative point of parallel imaging techniques is that they diminish SNR in proportion to the numbers of reduction factors. R is the factor by which the number of k-space samples is reduced. In standard Fourier imaging reducing the sampling density results in the reduction of the FOV, causing aliasing. In fact, SENSE reconstruction in the Cartesian case is efficiently performed by first creating one such aliased image for each array element using discrete Fourier transformation (DFT).
The next step then is to create a full-FOV image from the set of intermediate images. To achieve this one must undo the signal superposition underlying the fold-over effect. That is, for each pixel in the reduced FOV the signal contributions from a number of positions in the full FOV need to be separated. These positions form a Cartesian grid corresponding to the size of the reduced FOV.
The advantages are especially true for contrast-enhanced MR imaging such as dynamic liver MRI (liver imaging) , 3 dimensional magnetic resonance angiography (3D MRA), and magnetic resonance cholangiopancreaticography (MRCP).
The excellent scan speed of SENSE allows for acquisition of two separate sets of hepatic MR images within the time regarded as the hepatic arterial-phase (double arterial-phase technique) as well as that of multidetector CT.
SENSE can also increase the time efficiency of spatial signal encoding in 3D MRA. With SENSE, even ultrafast (sub second) 4D MRA can be realized.
For MRCP acquisition, high-resolution 3D MRCP images can be constantly provided by SENSE. This is because SENSE resolves the presence of the severe motion artifacts due to longer acquisition time. Longer acquisition time, which results in diminishing image quality, is the greatest problem for 3D MRCP imaging.
In addition, SENSE reduces the train of gradient echoes in combination with a faster k-space traversal per unit time, thereby dramatically improving the image quality of single shot echo planar imaging (i.e. T2 weighted, diffusion weighted imaging).