In this video, Kristopher Keppel, a Johns Hopkins School of Medicine medical student, discusses his research on dark-blood delayed enhancement imaging. This topic was presented during Blalock-Taussig-Thomas Heart Center Research Day at Johns Hopkins.
Hi there. My name is Chris Keppel. I'm a third year medical student here at Johns Hopkins. And I had the opportunity to present my project titled uh The Utility of Dark Blood Delayed Enhancement Imaging in patients with congenital heart disease. And added advantage in detecting myocardial fibrosis at the Blaylock Thomas Tausig Heart Center research symposium. So basically today in the world of cardiac MRI, um there's really one technique that is viewed as the gold standard for identifying fibrosis or scar tissue within the heart itself and that's called late gallium delayed enhancement imaging. Um And this method overall works quite well, but there is one drawback to it, which is that at times it can be difficult to distinguish between the blood that's in the heart and the fibrosis or scar tissue if it's in the very innermost wall of the heart. And that's because both the blood and the fibrosis or scar tissue appear very bright on this imaging. And so uh if when they write directly adjacent to one another, it could be diff it's difficult to tell what's what. So there has been one new technique that's come out uh that is proposed as a potential solution to this. And it's called dark blood delayed enhancement imaging. And it is very simple. It requires no extra cost, no extra time. All it requires is one small change in the programming of the imaging. And with that change, you're able to make the blood appear darker. And therefore allow for better identification of fibrosis or scar when it's in that innermost layer of the heart. And this method has picked up a good bit of steam in the adult world. Um but it's really not used at all in the pediatric world and in pediatric heart centers across the country. So what we wanted to do is look particularly at the utility of this method in patients with congenital heart disease in the pediatric world. And so we did that by looking at four cases of patients who are imaged right here at Johns Hopkins Hospital. And in each case, we were able to identify new findings uh on the dark blood imaging with totally new and unique findings not seen on the conventional uh delayed enhancement imaging. And uh in each case, this either altered the management of the patient or at least gave the treatment team a better understanding of the patient's physiology and and how they were functioning. So we absolutely still need to gather more evidence and put together more cases to show the utility of this technique. But our main takeaways for anyone watching, this would just be that you know, this new dark blood technique is simple. It's quick, it's easy and it's cheap. Um And it can identify new lesions and new areas of fibrosis that you may not otherwise see. And so we believe that it should be adopted more broadly in pediatric art centers across the country. And I'd be remiss if I didn't think thank my mentors uh with this research, Doctor Doshi and Doctor Shruti Rao. So just want to thank them as well as thank anyone for watching.
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