LAUSR

The purpose of the current study was to implement and validate joint real‐time acquisition of functional and late gadolinium‐enhancement (LGE) cardiac magnetic resonance (MR) images during free breathing. Inversion recovery cardiac real‐time images with a temporal resolution of 50 ms were acquired using a spiral trajectory (IR‐CRISPI) with a pre‐emphasis based on the gradient system transfer function during free breathing. Functional and LGE cardiac MR images were reconstructed using a low‐rank plus sparse model. Late gadolinium‐enhancement appearance, image quality, and functional parameters of IR‐CRISPI were compared with clinical standard balanced steady‐state free precession breath‐hold techniques in 10 patients. The acquisition of IR‐CRISPI in free breathing of the entire left ventricle took 97 s on average. Bland–Altman analysis and Wilcoxon tests showed a higher artifact level for the breath‐hold technique (p = 0.003), especially for arrhythmic patients or patients with dyspnea, but an increased noise level for IR‐CRISPI of the LGE images (p = 0.01). The estimated transmural extent of the enhancement differed by not more than 25% and did not show a significant bias between the techniques (p = 0.50). The ascertained functional parameters were similar for the breath‐hold technique and IR‐CRISPI, that is, with a minor, nonsignificant (p = 0.16) mean difference of the ejection fraction of 2.3% and a 95% confidence interval from −4.8% to 9.4%. IR‐CRISPI enables joint functional and LGE imaging in free breathing with good image quality but distinctly shorter scan times in comparison with breath‐hold techniques.