Proximal coronary artery stenosis: Three‐dimensional MRI with fat saturation and navigator echo

Abstract

The purpose of this study was to compare the diagnostic value of MR angiography (MRA) with conventional contrast angiography in coronary artery disease. Thirty-five patients underwent MRA and coronary angiography within 4 hours. Of these, three patients were investigated twice: once before and once after balloon angioplasty. The pulse sequence was a cardiac-triggered, single-slab, three-dimensional gradient-echo sequence, employing a spin-echo navigator echo measurement to track the variation of the diaphragm during the scan. The following segments of the coronary arteries were included in this prospective study: left main coronary artery, proximal and middle left anterior descending, proximal and middle left circumflex, proximal and middle right coronary artery, and intermediate branch, if present. In total, 176 segments were classified as normal or having a stenosis of less than 50% and as having a stenosis of more than 50%. Five patients were excluded because of lack of cooperation. Over all, 45 of 54 stenoses were detected and interpretable by MRA. Sensitivity, specificity, and positive and negative predictive values of MRA for detecting significant stenoses were 83%, 94%, 87%, and 93%, respectively. MRA identified significant stenoses within the major coronary arteries with a high degree of accuracy. Sensitivity and specificity are higher compared with exercise tests or scintigraphy or top of the precise localization.

Computed Tomography and Magnetic Resonance Imaging for Noninvasive Coronary Angiography and Plaque Imaging

“…30 Three major groups or "generations" of coronary MRA techniques can be discerned. From all techniques available, 2D breathhold CMRA scans, 31 3D retrospective respiratory navigator-gated coronary MRA, [32][33][34][35][36][37][38][39] and breathhold 3D CMRA 40,41 have been evaluated clinically (Table 2 and Figure 5).…”

High‐resolution selective three‐dimensional magnetic resonance coronary angiography with navigator‐echo technique: Segment‐by‐segment evaluation of coronary artery stenosis

“…Electrocardiography (ECG)-gated breath-hold and navigator-echo guided data acquisition have been evaluated to overcome image blurring due to cardiac and respiratory motion during the relatively long MR data acquisition process. Many imaging strategies have focused on the detection and quantification of the stenoses of only the proximal coronary arteries, but detection and quantification of the stenoses still remain unreliable (4,8,12,15).Transaxial sections used in those studies usually cover only the proximal segments of the major coronary arteries (8,12). However, not only the proximal coronary arteries, but also the mid and distal coronary arteries can be involved in the ischemic heart diseases.…”

“…Magnetic resonance coronary angiography (MRCA) has been evaluated by many authors since the late 1980s (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Electrocardiography (ECG)-gated breath-hold and navigator-echo guided data acquisition have been evaluated to overcome image blurring due to cardiac and respiratory motion during the relatively long MR data acquisition process.…”

“…Transaxial sections used in those studies usually cover only the proximal segments of the major coronary arteries (8,12). However, not only the proximal coronary arteries, but also the mid and distal coronary arteries can be involved in the ischemic heart diseases.…”

Coronary MR angiography: Respiratory motion correction with BACSPIN

“…Various refinements to the latter have been used to improve its relatively poor efficiency (6,10 -12), and to better track the motion of the coronary arteries during respiration (13)(14). Navigation techniques on the whole have not always produced image quality comparable to breath-held techniques (7), particularly in patients with irregular breathing patterns (15)(16).…”