Double Inversion Recovery Fast Spin Echo: Anatomy

Imaging Sequence Type:

  • Double Inversion Recovery Fast Spin Echo (GE /Toshiba), Turbo Spin Echo (Philps / Siemens)
  • A single image is typically acquired while the patient holds their breath for several heartbeats

Acquisition Mode: Single slice, single phase. One image per breath hold.

Image Contrast:

  • Black blood
  • Does not require intravenous gadolinium contrast
  • Proton Density Weighted (when TR is set to 2 RR intervals)
  • Poor T1-weighting (when TR is set to 1 RR interval)
  • T2 weighted when TE is long (e.g. >80 ms)

Imaging Options:

  • Fat suppression using an additional inversion pulse (also know as “Triple Inversion Recovery”)
  • Alternatively, fat suppression can be performed using fat saturation

Clinical Utility:

  • Good for anatomic delineation (e.g. pericardial thickness without effusion, neoplasm extent, etc.)
  • Good contrast between fat, muscle, blood.
  • Can be helpful for tissue characterization (e.g. neoplasm, myocardial edema).
  • Not good for assessing for gadolinium enhancement (poor T1-weighting).
  • Blood suppression does not work well when blood flow is slow or in-plane (not good for long axis imaging, or in patients with impaired systolic function).
  • Not good for wall thickness measurements (image acquisition is usually at mid-diastole, not end-diastole).
  • Inefficient. Usually only one image is acquired per breathhold.
  • Provides no functional information: cannot assess myocardial function or flow jets.