European Heart Journal Advance Access originally published online on June 29, 2005
European Heart Journal 2005 26(21):2313-2319; doi:10.1093/eurheartj/ehi391
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rapid and complete coronary arterial tree visualization with magnetic resonance imaging: feasibility and diagnostic performance
1Department of Internal Medicine/Cardiology, German Heart Institute, Augustenburger Platz 1, 13353 Berlin, Germany
2Department of Internal Medicine/Cardiology, University of Freiburg, Freiburg, Germany
3Philips Research Laboratories, Hamburg, Germany
Received 21 December 2004; revised 19 April 2005; accepted 22 April 2005; online publish-ahead-of-print 29 June 2005.
* Corresponding author. Tel: +49 30 4593 2457; fax: +49 30 4593 2458. E-mail address: jahnke{at}dhzb.de
Aims Current imaging of the coronary arteries with magnetic resonance coronary angiography (MRCA) is restricted to limited coverage of the coronary arterial tree and requires complex planning. We present and evaluate a rapid, single-scan MRCA approach with complete coverage of the coronary arterial tree.
Methods and results Fifty-five consecutive patients with suspected coronary artery disease underwent free-breathing, navigator-gated MRCA using a single three-dimensional volume with transversal slice orientation and nearly isotropic spatial resolution (1.2x1.2x1.4 mm3) with coverage of the whole heart [steady-state free precession (SSFP); TR/TE/flip angle: 5.3 ms/2.6 ms/90°; Philips Intera CV 1.5T]. The acquisition duration per heart beat was individually adapted to the cardiac rest period. Correction of respiratory motion was done using a patient-specific affine prospective navigator technique (two navigator beams: cranio-caudal position on the dome of the right hemidiaphragm and anterior–posterior position on the right chest wall; gating window 10 mm). The diagnostic performance of MRCA in detecting significant coronary stenoses was evaluated against X-ray angiography as the standard of reference (32 patients) using a 16-segment model. Effective scan duration was 18±6 min (navigator efficiency: 68±14%). In all examinations, the main epicardial vessels [left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA)], including their distal segments and major side branches (number of visible side branches: LAD, 2.0±0.9; LCX, 1.5±0.6; RCA, 2.3±0.9), were reliably visualized. Eighty-three per cent of all coronary segments were evaluable; sensitivity, specificity, and diagnostic accuracy were 78, 91, and 89%, respectively.
Conclusion The combination of an imaging sequence with an intrinsically high contrast (SSFP) and a sophisticated navigator technique (affine transformation) resulted in high quality, high resolution imaging of the whole coronary arterial tree within a short examination duration. Robustness and diagnostic accuracy may allow for a routine application in the near future.
Key Words: Magnetic resonance imaging • Magnetic resonance coronary angiography • Coronary artery disease • Whole heart imaging
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. J. de Feyter and R.-J. van Geuns Noninvasive Coronary Imaging: The Contest Between Magnetic Resonance and Computed Tomographic Coronary Angiography Circ Cardiovasc Imaging, September 1, 2008; 1(2): 89 - 91. [Full Text] [PDF]
|
|
|
|
|
|
A.-C. Pouleur, J.-B. le Polain de Waroux, J. Kefer, A. Pasquet, J.-L. Vanoverschelde, and B. L. Gerber Direct Comparison of Whole-Heart Navigator-Gated Magnetic Resonance Coronary Angiography and 40- and 64-Slice Multidetector Row Computed Tomography to Detect the Coronary Artery Stenosis in Patients Scheduled for Conventional Coronary Angiography Circ Cardiovasc Imaging, September 1, 2008; 1(2): 114 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Bluemke, S. Achenbach, M. Budoff, T. C. Gerber, B. Gersh, L. D. Hillis, W. G. Hundley, W. J. Manning, B. F. Printz, M. Stuber, et al. Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young Circulation, July 29, 2008; 118(5): 586 - 606. [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Gharib, V. B. Ho, D. R. Rosing, D. A. Herzka, M. Stuber, A. E. Arai, and R. I. Pettigrew Coronary Artery Anomalies and Variants: Technical Feasibility of Assessment with Coronary MR Angiography at 3 T Radiology, April 1, 2008; 247(1): 220 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Burgstahler and S. Schroeder Magnetic resonance imaging versus computed tomography for the detection of coronary stenosis: do we really have to focus on "stenoses"? Heart, November 1, 2007; 93(11): 1322 - 1324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A H Gershlick, M de Belder, J Chambers, D Hackett, R Keal, A Kelion, S Neubauer, D J Pennell, M Rothman, M Signy, et al. Role of non-invasive imaging in the management of coronary artery disease: an assessment of likely change over the next 10 years. A report from the British Cardiovascular Society Working Group Heart, April 1, 2007; 93(4): 423 - 431. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Sakuma, Y. Ichikawa, S. Chino, T. Hirano, K. Makino, and K. Takeda Detection of Coronary Artery Stenosis With Whole-Heart Coronary Magnetic Resonance Angiography J. Am. Coll. Cardiol., November 21, 2006; 48(10): 1946 - 1950. [Abstract] [Full Text] [PDF]
|
|