Magnetic resonance coronary angiography in heart transplant recipients

Mohiaddin, Raad H.; Bogren, Hugo G.; Lazim, F.; Keegan, Jennifer; Gatehouse, PD; Barbir, M.; Firmin, David N.; Yacoub, Mena

doi:10.1097/00019501-199608000-00006

Cited by 34 publications

(12 citation statements)

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“…In fact, MR coronary angiography has been reported to be clinically relevant in determining the origin and course of anomalous coronary arteries [19][20][21] for the follow-up of coronary artery bypass graft patencies [7,22] and in donor-recipient anastomoses for heart transplantation [23,24]. Nevertheless, the precise role of MR coronary angiography in depicting coronary artery atheromatosis and coronary artery stenosis must be still identified, although recent results have shown that MR coronary angiography is promising in detecting stenotic coronary artery lesions at the proximal and middle part of the vessels.…”

Section: Discussionmentioning

confidence: 99%

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Giorgi

Dymarkowski

Maes

et al. 2002

American Journal of Roentgenology

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OBJECTIVE. The goal of our study was to evaluate a new three-dimensional real-time navigator MR coronary angiography sequence to noninvasively visualize the coronary arteries.SUBJECTS AND METHODS. Fifteen healthy volunteers underwent MR coronary angiography with a new balanced turbo field-echo sequence in comparison with the standard turbo field-echo sequence. Signal-to-noise, blood-to-myocardium, blood-to-fat, and blood-topericardial fluid contrast ratios of the left and right coronary artery systems were measured. Image quality was graded, the length and diameter of the coronary arteries were measured, and the number of visible side branches was assessed.RESULTS. The balanced turbo field-echo images yielded a higher blood-to-myocardium and blood-to-pericardial fluid contrast ratio, a similar blood-to-fat contrast ratio, and a lower signal-to-noise ratio than the turbo field-echo images. On a 5-point grading scale (1, nondiagnostic or unreadable; 2, poor; 3, moderate; 4, good; 5, excellent), image quality was rated significantly better for the balanced turbo field-echo sequence than for the turbo field-echo sequence (left coronary artery, 4.0 ± 0.6 vs 3.6 ± 0.5 [ p = 0.015]; right coronary artery, 4.4 ± 0.4 vs 3.6 ± 0.4 [ p < 0.0001], respectively), resulting in a significantly longer segment of the three major coronary arteries visualized (left anterior descending coronary artery, 92 ± 21 mm vs 79 ± 24 mm; left circumflex coronary artery, 70 ± 7 mm vs 60 ± 18 mm; right coronary artery, 112 ± 28 mm vs 95 ± 27 mm) and a significantly higher number of side branches visualized (left anterior descending coronary artery, 2.9 ± 1.3 vs 1.5 ± 1.3; left circumflex coronary artery, 2.1 ± 1.7 vs 1.0 ± 1.2; right coronary artery, 3.7 ± 1.7 vs 2.6 ± 1.5). Mean imaging time per coronary artery was significantly shorter for the balanced turbo field-echo sequence (5.7 ± 1.0 min) than for the turbo field-echo sequence (8.4 ± 1.4 min) ( p < 0.0001).CONCLUSION. Compared with standard turbo field-echo MR coronary angiography, optimized balanced turbo field-echo MR coronary angiography improves the visualization of the coronary arteries and their side branches within a significantly shorter imaging time.oronary artery disease remains one of the leading causes of morbidity and mortality in the industrialized countries. Catheter angiography, currently the gold standard in detecting atheromatous coronary artery disease, is invasive and potentially harmful and necessitates the use of iodinated contrast material and radiation. Therefore, several techniques are under research to depict atheromatous changes in the coronary arteries in a noninvasive or less invasive fashion [1,2]. This technique could be used to screen or select patients for coronary catherization, which would significantly reduce the number of unnecessary diagnostic catherizations and would thus be potentially cost-effective. Three-dimensional (3D) MR coronary angiography techniques, performed either in breath-hold [3][4][5] or during free-breathing using a navigator [6,7...

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Section: Discussionmentioning

confidence: 99%

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Giorgi

Dymarkowski

Maes

et al. 2002

American Journal of Roentgenology

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“…Metallic clips and sternal sutures did not hamper these image assessments, although they might cause surrounding signal loss, create difficulties in shimming for fat-signal suppression, and preclude evaluation of coronary arteries. 36 Whereas no false-positive segments were detected, MRCA revealed 10 false-negative segments, 9 of which were graded as wall thickening by CCAG, presumably because of insufficient spatial resolution and contrast-tonoise ratio for distal lesions. In addition, 8 true-positive segments, which were graded as stenosis, were identified.…”

Section: Cardiac Allograft Vasculopathy By Mdct and Mrcamentioning

confidence: 96%

“…To our knowledge, only a few previous studies have compared whole-heart MRCA with CCAG for the feasibility of detecting significant coronary arterial stenosis in heart transplant recipients. 12, 36 The feasibility of this current whole-heart technique has not been established for detecting CAV, which has a more challenging etiology than CAD. In this study, the sensitivity of CAV detection was 60.0%, and the specificity of wholeheart MRCA was 100%.…”

Section: Cardiac Allograft Vasculopathy By Mdct and Mrcamentioning

confidence: 99%

Evaluation of Cardiac Allograft Vasculopathy by Multidetector Computed Tomography and Whole-Heart Magnetic Resonance Coronary Angiography

Nunoda

Machida

Sekikawa

et al. 2010

Circ J

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Background: Cardiac allograft vasculopathy (CAV) is a major complication that limits the long-term survival of recipients of heart transplants. In the present study the feasibility of 2 noninvasive approaches for detecting CAV (multidetector computed tomography (MDCT) and whole-heart magnetic resonance coronary angiography (MRCA)) was compared with conventional coronary angiography (CCAG). Methods and Results:Of 22 heart transplant recipients who underwent CCAG screening, 13 had only MDCT, 16 had only MRCA, and 7 had both noninvasive modalities. The coronary arterial tree was divided into 9 segments. Detection of vasculopathy by coronary segments was compared between 16-/64-detector computed tomography (CT) or MRCA and CCAG. The sensitivity of both 16- and 64-detector CT for diagnosing CAV was 69.6%, and specificity was 96.8%. The sensitivity and specificity by 64-detector CT alone were 90.0% and 97.5%, respectively; its positive and negative predictive values were 81.8% and 98.7% respectively. For MRCA, sensitivity was 60%, specificity, 100%, positive predictive value, 100% and negative predictive value, 92.2%. MRCA showed no false positives. Conclusions:MDCT, especially 64-detector CT, is feasible for detecting CAV, whereas MRCA currently shows limited sensitivity. (Circ J 2010; 74: 946 - 953)

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“…A RMC pode ainda ajudar a detectar doença arterial coronária associada ao transplante cardíaco 326 , complicações como doenças pericárdicas, massas intracavitárias 327 e os efeitos do tratamento de medicamentoso 328 no remodelamento associado ao uso prolongado de ciclosporina .…”

Section: Transplante Cardíacounclassified

Diretrizes SBC: ressonância e tomografia cardiovascular

2006

Arq. Bras. Cardiol.

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Magnetic resonance coronary angiography in heart transplant recipients

Cited by 34 publications

References 0 publications

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Evaluation of Cardiac Allograft Vasculopathy by Multidetector Computed Tomography and Whole-Heart Magnetic Resonance Coronary Angiography

Diretrizes SBC: ressonância e tomografia cardiovascular

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