Coronary artery bypass grafts: visualization with MR imaging.

As, Gomes; Lois, Juan F.; Drinkwater, Davis C.; Corday, Stephen R.

doi:10.1148/radiology.162.1.3491379

Cited by 67 publications

(17 citation statements)

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“…Although the patency of coronary artery grafts can be assessed by several noninvasive methods, [7][8][9][10][11][12][13][14]23) it has been generally accepted that EBCT is one of the best ways to detect graft patency. However, in the early stage of these studies, EBCT was only used as a tool for time-density curves of bypass grafts rather than to produce two-or three-dimensional images of the lumen of a coronary artery bypass graft.…”

Section: Discussionmentioning

confidence: 99%

“…However, angiography is an invasive and costly procedure with some risks 6) . Therefore, noninvasive modalities such as exercise electrocardiography, 7) exercise thallium scintigraphy, 8) exercise radionuclide angiography, 9) Doppler echocardiography, 10) and magnetic resonance imaging [11][12][13][14] have been developed, but they have been evaluated as having limited usefulness due to low diagnostic accuracy.…”

Section: Arteriesmentioning

confidence: 99%

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Noninvasive Detection of Coronary Artery Bypass Graft Patency by Intravenous Electron Beam Computed Tomographic Angiography.

et al. 2003

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SUMMARYThis study evaluates the usefulness of intravenous electron beam computed tomographic angiography (EBA) for the detection of coronary artery bypass graft patency in 43 patients (33 men and 10 women, mean age, 65 years) who had coronary artery bypass graft surgery. EBA was performed a few days before selective bypass graft angiography (SGA). Forty axial cross-sections of angiographic images of the heart were acquired consecutively by an electrocardiographic trigger signal at 40% of the RR interval, which corresponds to the end-systolic phase. EBA data were reconstructed as a three-dimensional shaded surface display of the heart and bypass grafts. Detectability of the patency of bypass grafts was evaluated, taking selective angiographic images of the bypass grafts as a gold standard. One hundred and nine grafts (96%) out of 114 grafts were subjected to evaluation: 37 grafts were left internal mammary artery grafts (LIMA), 7 were right internal mammary artery grafts (RIMA), 6 were gastroepiploic artery grafts (GEA), 7 were free gastroepiploic artery grafts with venous drainage (free-GEA), 7 were radial artery grafts (RAG), and 45 were saphenous vein grafts (SVG). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBA were 98%, 100%, 100%, 91%, and 98%, respectively. EBA sampled at the end-systolic period was determined to be useful for the detection of coronary artery bypass graft patency and occlusion. (Jpn Heart J 2003; 44: 811-822) Key words: Electron beam computed tomography, Coronary artery bypass grafting, Angiography POSTOPERATIVE angina occurs with a frequency of 30% in the first year after coronary artery bypass graft (CABG) surgery.1) It may result from either graft occlusion, or progression of the atherosclerotic lesion of the native coronary From the

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Section: Discussionmentioning

confidence: 99%

Section: Arteriesmentioning

confidence: 99%

Noninvasive Detection of Coronary Artery Bypass Graft Patency by Intravenous Electron Beam Computed Tomographic Angiography.

et al. 2003

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“…The LCX graft was, on occasion, difficult to distinguish from the coronary sinus at the level of the left ventricle. Other authors have commented on structures that may be confused with bypass grafts or native coronary arteries, including the pericardial reflections, coronary veins, and postsurgical defects in the pericardium.4 9 Gomes et al 4 commented on the importance of following bypass grafts through successive images from the position near native coronary In this study we considered grafts known to have been placed at the time of surgery that were not seen by MR as occluded, although it is possible that if flow through a native graft is slow it will not have the typical appearance of a signal-free lumen. Blood vessels are visualized with the spin-echo technique by the appearance of a signal-free lumen10 because the spins of moving blood that are pulsed move out of the imaging plane.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging to evaluate patency of aortocoronary bypass grafts.

et al. 1987

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To assess the efficacy of magnetic resonance (MR) imaging in evaluating graft patency after coronary bypass surgery, 20 patients who had prior surgery (average 5.5 years, range 1.5 to 14) and recent cardiac catheterization because of chest pain were studied. No patient had surgical intervention or change in symptoms in the time interval between catheterization and MR imaging. These 20 patients had a total of 47 grafts, defined as proximal anastomoses: 20 to the left anterior descending or diagonal artery (LAD), 13 to the left circumflex artery marginal branches (LCX), and 14 to the right coronary artery or posterior descending artery (RCA). The patients underwent cardiac and respiratory gated MR scans in a 0.5 tesla magnet with an echo time of 22 msec and two repetitions in a 128 x 256 matrix. In-plane resolution was 2.7 mm. Every patient had a scan in the transaxial plane and some underwent scanning in the sagittal and coronal planes as well. A graft was considered patent by MR when a signal-free lumen was visualized in an anatomic position consistent with that of a bypass graft, had a lumen larger than the native vessels, was seen on more than one slice, and was seen at a level higher than that of the native vessels. If a known graft was not seen it was considered occluded. The scans were interpreted by consensus of two physicians aware of the operative but not the cardiac catheterization data. Twenty-six of 29 patent grafts and 13 of 18 occluded grafts were correctly classified (sensitivity 90%, specificity 72%). Eighteen of 20 (90%) LAD grafts, 11 of 14 (79%) RCA grafts, and 11 of 13 (85%) LCX grafts were correctly classified. When the results from three patients with technically poor studies because of poor cardiac gating were excluded, the overall sensitivity and specificity were 92% and 85%, respectively. This study demonstrates the high sensitivity and moderate specificity of MR for evaluating the patency of coronary artery bypass grafts, particularly LAD grafts. Circulation 76, No. 4, 786-791, 1987. INCREASING NUMBERS of patients with previous coronary artery bypass surgery

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“…Die nichtinvasive Beurteilung wird erschwert durch die geringen Gefäßkali-ber von 2-5 mm, die schnelle dreidimensionale Bewegung während des Herzzyklus und Signalverluste durch epikardiales Fettgewebe. Die bisher umfangreichsten Studien wurden mit der Time-of-Flight-(TOF-) und Phasenkontrast-(PC-)Magnetresonanzangiographie (MRA) durchgeführt [1,9,15,20,21,25,26,28,29]. Allen diesen Studien gemeinsam war eine geringe Bildqualität aufgrund der Atmungsund Bewegungsartefakte infolge der langen Akquisitionszeiten.…”

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