Contrast-enhanced whole-heart coronary MRA at 3.0T for the evaluation of cardiac venous anatomy

Abstract

This study was designed to evaluate the value of contrast-enhanced whole-heart coronary MRA (CMRA) at 3.0T in depicting the cardiac venous anatomy. In cardiac resynchronization therapy (CRT), left ventricular (LV) pacing is achieved by positioning the LV lead in one of the tributaries of the coronary sinus (CS). Pre-implantation knowledge of the venous anatomy may help determine whether transvenous LV lead placement for CRT is feasible. Images of 51 subjects undergoing contrast-enhanced whole-heart CMRA at 3.0T were retrospectively analyzed. Data acquisition was performed using electrocardiography-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence. A 32-element cardiac coil was used for data acquisition. The visibility of the cardiac veins was graded visually using a 4-point scale (1: poor–4: excellent). The paired Student t test was used to evaluate differences in diameters of the ostium of the CS in anteroposterior and superoinferior direction. The cardiac veins were finally evaluated in 48 subjects with three anatomic variations. The diameter of the CS ostium in the superoinferior direction (1.13 ± 0.26 cm) was larger than in the anteroposterior direction (0.82 ± 0.19 cm) (P < 0.05). The mean visibility score of CS, posterior interventricular vein, posterior vein of the left ventricle, left marginal vein, and anterior interventricular vein was 4.0 ± 0.0, 3.4 ± 0.5, 3.4 ± 0.5, 3.0 ± 0.8, and 3.3 ± 0.5, respectively. In conclusion, contrast-enhanced whole-heart CMRA at 3.0T can depict the normal and variant cardiac venous anatomy.

“One-stop-shop” cardiac MRI at 3.0T for the detection of coronary artery disease

“…Whole-heart coronary MRA with additional slow infusion of contrast material (0.15 mmol/kg at 0.3 ml/sec) was acquired after perfusion imaging. A navigator-gated, electrocardiography-triggered, fat saturated, segmented 3D fast low-angle shot sequence [1,2], with the following image parameters was used: TR/TE/flip-angle = 3.0/1.4/20°, readout bandwidth = 610 Hz/pixel, voxel size = 1.3 × 1.3 × 1.3 mm 3 interpolated to 0.65 × 0.65 × 0.65 mm 3 , GRAPPA factor = 2, inversion prepulse delay = 200 ms. Delayed enhancement images were acquired by phase sensitive inversion recovery sequences after coronary MRA for viability study.…”

Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT

“…Lastly, these studies were done at 1.5T using a 6-channel coil. Studies have shown that image quality can be improved by performing studies on a 3T MRI with a 32 channel coil for maximum SNR [6]. However, most CMR studies are still performed at 1.5T because of better consistency of SSFP imaging at 1.5T [14].…”

“…Studies using contrast-enhanced MRI for coronary vein imaging have shown that the technique is capable of visualizing the coronary venous vasculature [5, 6]. However, none of these studies have had corresponding X-ray venograms to validate the existence of the coronary veins visualized by MRI, and most studies have small sample sizes [7].…”

Molecular Imaging to Monitor Left Ventricular Remodeling in Heart Failure

“…Myocardial perfusion can be measured without CA by techniques of arterial spin labeling [71] and blood oxygen level-dependent contrast [15]. CA is used in myocardial angiography, where blood flow inside coronary arteries can be measured since the blood flow is alternated in the area of MI compared to the surrounding heart muscle [72]. CA-MRA has also been used to determine microvascular obstruction in swine acute MI model with high accuracy [22,71].…”