The presented MR approach reliably identifies patients with coronary artery stenoses and provides information on the amount of compromised myocardium, even when perfusion abnormalities are confined to the subendocardial layer. This modality may qualify for its clinical application in the management of coronary artery disease.

Dynamic supine MR imaging performed with a closed-configuration unit before and after rectal contrast agent administration appears to be an alternative to sitting MR defecography performed with an open-configuration unit for diagnosis of clinically relevant pelvic floor abnormalities.

Fast imaging techniques allow monitoring of contrast medium (CM) first-pass kinetics in a multislice mode. Employing shorter recovery times improves cardiac coverage during first-pass conditions, but potentially flattens signal response in the myocardium. The aim of this study was therefore to compare in patients with suspected coronary artery disease (CAD) two echo-planar imaging strategies yielding either extended cardiac coverage or optimized myocardial signal response (protocol A/B, six/four slices; preparation pulse, 60°/90°; delay time, 10/120 msec; readout flip angle, 10°/50°; respectively). In phantoms and myocardium of normal volunteers (N ‫؍‬ 10) the CM-induced signal increase was 2.5-3 times higher with protocol B (P < 0.005) than with protocol A. For the detection of individually diseased coronary arteries (>1 stenosis with >50% diameter reduction on quantitative coronary angiography (QCA)), receiver-operator characteristics of protocol B (signal upslope in 32 sectors/heart) yielded a sensitivity/specificity of 82%/73%, which was superior to protocol A (P < 0.05, N ‫؍‬ 14). For the overall detection of CAD, the sensitivity/specificity of protocol B was 85%/81%. An adequate signal response in the myocardium is crucial for a reliable detection of perfusion deficits during firstpass conditions. The presented protocol B detects CAD with a sensitivity and specificity similar to scintigraphic techniques.

Contrast-enhanced three-dimensional MR angiography is well suited for the characterization of arterial grafts, for planning subsequent vascular interventions, and for excluding further lesions.

No abstract