Measurement of Absolute Epicardial Coronary Artery Flow and Flow Reserve With Breath-Hold Cine Phase-Contrast Magnetic Resonance Imaging

Clarke, Geoffrey D.; Eckels, Robin; Chaney, Curtis; Smith, Dorothy; Dittrich, J; Hundley, W. Gregory; NessAiver, Moriel; Li, Hong Fang; Parkey, Robert W.; Peshock, Ronald M

doi:10.1161/01.cir.91.10.2627

Cited by 94 publications

(36 citation statements)

References 20 publications

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“…28 Because the breath hold techniques applied in previous studies resulted in a temporal resolution of Ͻ100 ms, the investigators limited themselves to the LAD, except for 1 reported case of flow measurements in the RCA. 17,19,26,27 With this study we extend MR flow measurements to the RCA, which was possible by using shorter acquisition times per heartbeat. Even though we did not reach the temporal resolution set forth by Hofman et al, 28 we were able to come very close to this value, thus minimizing motion-induced blurring and inaccuracies.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Determination of Coronary Blood Flow Velocity With Cardiovascular Magnetic Resonance in Patients After Stent Deployment

et al. 2003

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Background-In patients with coronary artery stents, no direct noninvasive coronary artery imaging is possible with magnetic resonance (MR). A well-established method for the assessment of the functional significance of a coronary lesion is the measurement of coronary flow reserve by invasive intracoronary Doppler. The purpose of the study was to determine coronary flow velocity reserve (CFVR) with MR after stent deployment. Methods and Results-Thirty-eight patients after successful PTCA and stent deployment were included. CFVR was measured perpendicular to the artery distal to the stent using phase-contrast velocity quantification at rest and during adenosine-stimulated hyperemia with a 1.5T MR tomograph (ACS NT, Philips). Measurements were repeated after 3 months and compared with invasive coronary angiography. In 18 patients, additional invasive Doppler flow measurements were obtained. CFVR could be determined in 29 of 38 (76%) of the patients. After 3 months, significant differences were obtained between coronary arteries with and without restenosis. Using a threshold of 1.2, a sensitivity of 83% with a specificity of 94% was achieved for Ն75% stenoses. CFVR with CMR was similar to Doppler results (rϭ0.87), with a mean relative difference of 7.5%. Conclusions-In patients with preserved coronary microcirculating vasoreactivity that are suitable for MR coronary angiography and flow assessments, CMR measures of coronary blood flow velocities reserve may be used to detect in-stent restenosis.

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Section: Discussionmentioning

confidence: 99%

Noninvasive Determination of Coronary Blood Flow Velocity With Cardiovascular Magnetic Resonance in Patients After Stent Deployment

et al. 2003

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“…13,15,17 At the time of analysis of the MRI data, paired magnitude images and velocity maps were displayed on an image-processing workstation. On the baseline and peak flow image sets, a region of interest (ROI) was generated by manually tracing the vessel lumen on the magnitude image.…”

Section: Mri Techniquementioning

confidence: 99%

“…17,18 For this terminal portion of the cardiac cycle, we estimated flow to be the same as the flow in the last imaged diastolic frame. CAFR was defined as the ratio of peak flow (measured after adenosine infusion) to baseline flow.…”

Section: Mri Techniquementioning

confidence: 99%

Assessment of Coronary Arterial Restenosis With Phase-Contrast Magnetic Resonance Imaging Measurements of Coronary Flow Reserve

et al. 2000

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Background-After successful percutaneous coronary arterial revascularization, 25% to 60% of subjects have restenosis, a recurrent coronary arterial narrowing at the site of the intervention. At present, restenosis is usually detected invasively with contrast coronary angiography. This study was performed to determine if phase-contrast MRI (PC-MRI) could be used to detect restenosis noninvasively in patients with recurrent chest pain after percutaneous revascularization. Methods and Results-Seventeen patients (15 men, 2 women, age 36 to 77 years) with recurrent chest pain Ͼ3 months after successful percutaneous intervention underwent PC-MRI measurements of coronary artery flow reserve followed by assessments of stenosis severity with computer-assisted quantitative coronary angiography. The intervention was performed in the left anterior descending coronary artery in 15 patients, one of its diagonal branches in 2 patients, and the right coronary artery in 1 patient. A PC-MRI coronary flow reserve value Յ2.0 was 100% and 82% sensitive and 89% and 100% specific for detecting a luminal diameter narrowing of Ն70% and Ն50%, respectively. Conclusions-Assessments of coronary flow reserve with PC-MRI can be used to identify flow-limiting stenoses (luminal diameter narrowings Ͼ70%) in patients with recurrent chest pain in the months after a successful percutaneous intervention.

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“…In addition, a cross-sectional view of the LAD was obtained that was perpendicular to the direction of blood flow to ensure that minimal through-plane motion and partial volume effects were present when flow data were analyzed. 16 In arterial segments with a potential stenosis, cross-sectional images of the vessel were obtained along a straight segment of the vessel distal to the most distal area of dropout. As shown previously, this technique allows visualization of the anterior epicardial arterial circulation to within 2.7 cm of the cardiac apex.…”

Section: Mri Techniquementioning

confidence: 99%

“…13,16,17 Velocity maps were generated by pixel-to-pixel subtraction of the phase contrast phase images and the application of a correction algorithm designed to remove background phase error. 12,18 The paired magnitude images and velocity maps were displayed on an image-processing workstation where flow calculations for each image set (baseline and peak flow with adenosine) were performed.…”

Section: Mri Techniquementioning

confidence: 99%

Visualization and Functional Assessment of Proximal and Middle Left Anterior Descending Coronary Stenoses in Humans With Magnetic Resonance Imaging

et al. 1999

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Background-Coronary artery bypass grafting improves survival in patients with Ͼ70% luminal diameter narrowing of the 3 major epicardial coronary arteries, particularly if there is involvement of the proximal portion of the left anterior descending (LAD) coronary artery. Measurement of coronary flow reserve can be used to identify functionally important luminal narrowing of the LAD artery. Although magnetic resonance imaging (MRI) has been used to visualize coronary arteries and to measure flow reserve noninvasively, the utility of MRI for detecting significant LAD stenoses is unknown. Methods and Results-Thirty subjects (23 men, 7 women, age 36 to 77 years) underwent MRI visualization of the left main and LAD coronary arteries as well as measurement of flow in the proximal, middle, or distal LAD both at rest and after intravenous adenosine (140 g/kg per minute). Immediately thereafter, contrast coronary angiography and when feasible, intracoronary Doppler assessments of coronary flow reserve, were performed. There was a statistically significant correlation between MRI assessments of coronary flow reserve and (a) assessments of coronary arterial stenosis severity by quantitative coronary angiography and (b) invasive measurements of coronary flow reserve (PϽ0.0001 for both). In comparison to computer-assisted quantitative coronary angiography, the sensitivity and specificity of MRI for identifying a stenosis Ͼ70% in the distal left main or proximal/middle LAD arteries was 100% and 83%, respectively. Conclusions-Noninvasive MRI measures of coronary flow reserve correlated well with similar measures obtained with the use of intracoronary Doppler flow wires and predicted significant coronary stenoses (Ͼ70%) with a high degree of sensitivity and specificity. MRI-based measurement of coronary flow reserve may prove useful for identification of patients likely to obtain a survival benefit from coronary artery bypass grafting. (Circulation. 1999;99:3248-3254.)

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Measurement of Absolute Epicardial Coronary Artery Flow and Flow Reserve With Breath-Hold Cine Phase-Contrast Magnetic Resonance Imaging

Cited by 94 publications

References 20 publications

Noninvasive Determination of Coronary Blood Flow Velocity With Cardiovascular Magnetic Resonance in Patients After Stent Deployment

Noninvasive Determination of Coronary Blood Flow Velocity With Cardiovascular Magnetic Resonance in Patients After Stent Deployment

Assessment of Coronary Arterial Restenosis With Phase-Contrast Magnetic Resonance Imaging Measurements of Coronary Flow Reserve

Visualization and Functional Assessment of Proximal and Middle Left Anterior Descending Coronary Stenoses in Humans With Magnetic Resonance Imaging

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