Current 2D black blood coronary vessel wall imaging suffers from a relatively limited coverage of the coronary artery tree. Hence, a 3D approach facilitating more extensive coverage would be desirable. The straightforward combination of a 3D-acquisition technique together with a dual inversion prepulse can decrease the effectiveness of the black blood preparation. To minimize artifacts from insufficiently suppressed blood signal of the nearby blood pools, and to reduce residual respiratory motion artifacts from the chest wall, a novel local inversion technique was implemented. The combination of a nonselective inversion prepulse with a 2D selective local inversion prepulse allowed for suppression of unwanted signal outside a userdefined region of interest. Among 10 subjects evaluated using a 3D-spiral readout, the local inversion pulse effectively suppressed signal from ventricular blood, myocardium, and chest wall tissue in all cases. Bright blood coronary magnetic resonance angiography (MRA) has shown great potential for noninvasive assessment of intraluminal coronary artery disease (1), but angiography provides minimal information on the magnitude of underlying atherosclerotic plaque. Our current understanding is that luminal disease underestimates atherosclerotic plaque burden and that a majority of acute coronary syndromes occur at sites with nonflow limiting stenoses (2). Thus, a noninvasive approach for direct coronary plaque imaging would be desirable to allow for assessment of subclinical disease.Recently, 2D black blood coronary MR vessel wall and plaque imaging using a dual inversion (Dual-IR) prepulse (3) has been reported (4 -7). Respiratory motion artifacts can be minimized by the use of breathholding (5,6) or respiratory navigators (4,7) and both techniques allow for direct assessment of coronary wall thickness and the visualization of focal atherosclerotic plaque in the coronary vessel wall. However, for clinical use, 3D approaches would be advantageous as they allow for a more extensive coverage of the coronary artery tree, improved SNR, and thus the potential for higher spatial image resolution. Unfortunately, the straightforward combination of a 3D-acquisition technique with a Dual-IR prepulse can decrease the effectiveness of the Dual-IR preparation because of the reinversion of a relatively large amount of ventricular blood. To overcome this weakness, we implemented a 2D selective local inversion prepulse, thereby preserving the signal from the area of interest while minimizing unwanted signal from adjacent tissues and intracavitary blood pool. To optimize SNR and to maintain a short acquisition window, data acquisition was performed using 3D spiral imaging.
METHODSFree-breathing 3D coronary vessel wall imaging using a local inversion technique and spiral image acquisition was implemented on a commercial Philips Gyroscan ACS-NT MR scanner (Philips Medical Systems, Best, Netherlands) equipped with a PowerTrak 6000 gradient (23 mT/m, 220 s rise time) system. Written informed consent was obtain...