Additive value of 3T cardiovascular magnetic resonance coronary angiography for detecting coronary artery disease

Zhang, Lijun; Song, Xiaoyan; Dong, Li; Li, Jianan; Dou, Ruiyu; Fan, Zhanming; An, Jing; Li, Debiao

doi:10.1186/s12968-018-0450-2

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…One could use a combination of imaging modalities to accomplish this, such as using both CT-to acquire the coronary anatomy and estimate the basal coronary flow rate through allometric scaling as described by Choy and Kassab (15)-and positron emission tomography (PET)-to assess the patient-specific CFR and determine the hyperemic response (34). Perhaps a more feasible clinical solution would be to use MRI which can acquire both anatomy and flow directly (35,36). The use of PCMR to directly estimate the pressure gradient across a coronary stenosis has also been shown to be feasible, which has the potential to eliminate the need for CFD flow simulations altogether (37).…”

Section: Discussionmentioning

confidence: 99%

Effect of Patient-Specific Coronary Flow Reserve Values on the Accuracy of MRI-Based Virtual Fractional Flow Reserve

Hair

Timmins

Sayed

et al. 2021

Front. Cardiovasc. Med.

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The purpose of this study is to investigate the effect of varying coronary flow reserve (CFR) values on the calculation of computationally-derived fractional flow reserve (FFR). CFR reflects both vessel resistance due to an epicardial stenosis, and resistance in the distal microvascular tissue. Patients may have a wide range of CFR related to the tissue substrate that is independent of epicardial stenosis levels. Most computationally based virtual FFR values such as FFRCT do not measure patient specific CFR values but use a population-average value to create hyperemic flow conditions. In this study, a coronary arterial computational geometry was constructed using magnetic resonance angiography (MRA) data acquired in a patient with moderate CAD. Coronary flow waveforms under rest and stress conditions were acquired in 13 patients with phase-contrast magnetic resonance (PCMR) to calculate CFR, and these flow waveforms and CFR values were applied as inlet flow boundary conditions to determine FFR based on computational fluid dynamics (CFD) simulations. The stress flow waveform gave a measure of the functional significance of the vessel when evaluated with the physiologically-accurate behavior with the patient-specific CFR. The resting flow waveform was then scaled by a series of CFR values determined in the 13 patients to simulate how hyperemic flow and CFR affects FFR values. We found that FFR values calculated using non–patient-specific CFR values did not accurately predict those calculated with the true hyperemic flow waveform. This indicates that both patient-specific anatomic and flow information are required to accurately non-invasively assess the functional significance of coronary lesions.

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Section: Discussionmentioning

confidence: 99%

Effect of Patient-Specific Coronary Flow Reserve Values on the Accuracy of MRI-Based Virtual Fractional Flow Reserve

Hair

Timmins

Sayed

et al. 2021

Front. Cardiovasc. Med.

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“…One recent study showed that multiparametric exercise stress CMR accurately correlated with FFR coronary angiography, indicating feasibility [ 23 ]. A recent study by Zhang et al showed that the 3-Tesla (T) CMR coronary angiography improved the sensitivity and diagnostic accuracy for CAD detection compared to myocardial perfusion imaging and LGE alone [ 24 ]. Another study which included symptomatic postmenopausal women proposed a combination of two negative stress imaging results (stress CMR with stress echocardiography or single positron emission tomography (SPECT)) for detection of CAD and for risk stratification purposes as this strategy yielded higher accuracy [ 25 ].…”

Section: The Role Of Cmr In the Detection Of Significant Cadmentioning

confidence: 99%

Contemporary Role of Cardiac Magnetic Resonance in the Management of Patients with Suspected or Known Coronary Artery Disease

et al. 2021

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Cardiac magnetic resonance imaging (CMR) is a useful non-invasive radiation-free imaging modality for the management of patients with coronary artery disease (CAD). CMR cine imaging provides the “gold standard” assessment of ventricular function, late gadolinium enhancement (LGE) provides useful data for the diagnosis and extent of myocardial scar and viability, while stress imaging is an established technique for the detection of myocardial perfusion defects indicating ischemia. Beyond its role in the diagnosis of CAD, CMR allows accurate risk stratification of patients with established CAD. This review aims to summarize the data regarding the role of CMR in the contemporary management of patients with suspected or known coronary artery disease.

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“…As these challenges are tackled and the technique matures, integrated protocols in which coronary MRA is added to other cardiac MRI examinations as a "one-stop-shop-test" are likely to improve the diagnostic and prognostic performance of the MRI examination. For example, the addition of free-breathing whole heart contrast-enhanced coronary MRA at 3 T to the combination of stress/rest myocardial perfusion imaging and late gadolinium enhancement (LGE) image significantly improved the sensitivity and diagnostic accuracy of detection of ≥ 50% stenosis as diagnosed by CAG (per-patient bases, sensitivity 100% vs. 76.5%, p < 0.01, accuracy 89.1% vs. 73.9%, p < 0.01) [42]. Although not specifically shown, a similar benefit of non-contrast coronary MRA is highly expected.…”

Section: Current Status Of Non-contrast Coronary Mramentioning

confidence: 99%

Non-contrast coronary magnetic resonance angiography: current frontiers and future horizons

Kato

Ambale-Venkatesh

Kassai

et al. 2020

Magn Reson Mater Phy

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Coronary magnetic resonance angiography (coronary MRA) is advantageous in its ability to assess coronary artery morphology and function without ionizing radiation or contrast media. However, technical limitations including reduced spatial resolution, long acquisition times, and low signal-to-noise ratios prevent it from clinical routine utilization. Nonetheless, each of these limitations can be specifically addressed by a combination of novel technologies including super-resolution imaging, compressed sensing, and deep-learning reconstruction. In this paper, we first review the current clinical use and motivations for non-contrast coronary MRA, discuss currently available coronary MRA techniques, and highlight current technical developments that hold unique potential to optimize coronary MRA image acquisition and post-processing. In the final section, we examine the various research-based coronary MRA methods and metrics that can be leveraged to assess coronary stenosis severity, physiological function, and atherosclerotic plaque characterization. We specifically discuss how such technologies may contribute to the clinical translation of coronary MRA into a robust modality for routine clinical use.

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Additive value of 3T cardiovascular magnetic resonance coronary angiography for detecting coronary artery disease

Cited by 16 publications

References 23 publications

Effect of Patient-Specific Coronary Flow Reserve Values on the Accuracy of MRI-Based Virtual Fractional Flow Reserve

Effect of Patient-Specific Coronary Flow Reserve Values on the Accuracy of MRI-Based Virtual Fractional Flow Reserve

Contemporary Role of Cardiac Magnetic Resonance in the Management of Patients with Suspected or Known Coronary Artery Disease

Non-contrast coronary magnetic resonance angiography: current frontiers and future horizons

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