Cardiovascular magnetic resonance at 3.0T: Current state of the art

Oshinski, John N.; Delfino, Jana G.; Sharma, Puneet; Gharib, Ahmed M.; Pettigrew, Roderic I.

doi:10.1186/1532-429x-12-55

Cited by 79 publications

(88 citation statements)

References 92 publications

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“…These results are substantially in line with those of the Euro-CMR (0.5% of studies performed with 3 T machines) and confirm that both the higher scanners' costs and technical challenges (field homogeneity reduction with increased susceptibility artifacts and radiofrequency-induced power deposition) associated with high field systems are still perceived as major drawbacks by most centers limiting their diffusion and utilization in the territory only to few research sites regardless significant recent improvements and potential advantages of 3 T imaging in CMR [5,10,11].…”

Section: Technical Equipment and Acquisition Protocolsmentioning

confidence: 50%

Italian registry of cardiac magnetic resonance

Francone¹,

Cesare²,

Cademartiri³

et al. 2014

European Journal of Radiology

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Objectives Forty sites were involved in this multicenter and multivendor registry, which sought to evaluate indications, spectrum of protocols, impact on clinical decision making and safety profile of cardiac magnetic resonance (CMR). Materials and methods Data were prospectively collected on a 6-month period and included 3376 patients (47.2 ± 19 years; range 1-92 years). Recruited centers were asked to complete a preliminary general report followed by a single form/patient. Referral physicians were not required to exhibit any specific certificate of competency in CMR imaging. Results Exams were performed with 1.5 T scanners in 96% of cases followed by 3 T (3%) and 1 T (1%) magnets and contrast was administered in 84% of cases. The majority of cases were performed for the workup of inflammatory heart disease/cardiomyopathies representing overall 55.7% of exams followed by the assessment of myocardial viability and acute infarction (respectively 6.9% and 5.9% of patients). In 49% of cases the final diagnosis provided was considered relevant and with impact on patient's clinical/therapeutic management. Safety evaluation revealed 30 (0.88%) clinical events, most of which due to patient's preexisting conditions. Radiological reporting was recorded in 73% of exams. Conclusions CMR is performed in a large number of centers in Italy with relevant impact on clinical decision making and high safety profile. © 2013 Elsevier Ireland Ltd

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Section: Technical Equipment and Acquisition Protocolsmentioning

confidence: 50%

Italian registry of cardiac magnetic resonance

Francone¹,

Cesare²,

Cademartiri³

et al. 2014

European Journal of Radiology

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“…In addition, 3T MRI may require a longer acquisition time than 1.5T MRI because of heat generation due to the high magnetic fields. 6,7) …”

Section: Discussionmentioning

confidence: 99%

“…In addition, 3T MRI may require a longer acquisition time than 1.5T MRI because of heat generation due to the high magnetic fields. 6,7) WHCA with steady state free precession (SSFP) at 1.5T MRI provides high signal intensity for blood. 8) However, SSFP cannot be used for WHCA at 3.0T MRI, because of the high specific absorption rate.…”

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confidence: 99%

Diagnostic Accuracy of Three Different Protocols for 3.0T Coronary Magnetic Resonance Angiography

et al. 2016

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SummaryThe usefulness of coronary magnetic resonance angiography (cMRA) has been reported, although the difference in the diagnostic accuracy of different protocols has not been established.We compared conventional coronary angiography (CAG) and cMRA, conducted within 6 months in 24 consecutive patients between September 2012 and July 2014. Three cMRA protocols were examined, cMRA1, free-breathing wholeheart coronary angiography (WHCA) without contrast; cMRA2, free-breathing WHCA with contrast; and cMRA3, breath-hold steady-state free precession with contrast using a 3.0 T scanner. Image quality was graded on a 4-point scale: 1) nonassessable; 2) assessable, fair vessel contrast; 3) assessable, good vessel contrast; and 4) assessable, excellent vessel contrast. Significant narrowing of the coronary arteries was visually assessed.Stenosis was observed in 34 segments, with a prevalence of 10.3%. For cMRA1, cMRA2, and cMRA3, the numbers of assessable segments were 245 (74.2%), 287 (87.0%), and 164 (49.7%), respectively (P < 0.001 by the McNemar test). For assessable segments, the sensitivity, specificity, positive predictive value, and negative predictive value were 89.3%, 99.1%, 92.6%, and 98.6% for cMRA1, 90.0%, 98.1%, 84.4%, and 98.8% for cMRA2, and 76.5%, 93.9%, 59.1%, and 97.1% for cMRA3, respectively. For the assessable segments, the image quality score was better with cMRA2 than with the other two protocols.cMRA is a useful modality to rule out coronary artery disease, especially the cMRA2 protocol, which performed better than the other two protocols. (Int Heart J 2016; 57: 535-540) Key words: Whole-heart coronary angiography, Steady-state free precession, Coronary artery disease X -ray coronary angiography (CAG) is the current gold standard for the assessment of coronary artery disease (CAD), but it carries the risk of complications because it is an invasive procedure. However, magnetic resonance (MR) imaging technology is noninvasive and radiationfree.1) The ability to evaluate the coronary arteries using electrocardiogram (ECG)-gated MR imaging was first reported in 1987;2) however, only the proximal coronary arteries can be evaluated using this method. One of the major limitations of coronary MR angiography (cMRA) is the need to effectively suppress respiratory motion. Breath-hold imaging is one of the protocols used to solve this problem,3) in addition to freebreathing and 3-dimensional cMRA, 4,5) which result in better image quality than breath-hold imaging.Improvements in cMRA image quality have also been achieved by using gradient performance, radiofrequency-receiving coils, and advanced data acquisition techniques. However, whole heart cMRA requires a long acquisition time, whereas in the clinical setting, evaluation of only the main branch or the proximal portion of the coronary artery is sometimes required. 3T MRI has a better signal-to-noise ratio and higher spatial resolution than 1.5T MRI. On the other hand, cMRA is particularly useful for the assessment of coronary arteries. In addition, 3T MR...

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“…Viele Anwendungen der Herz-MRT weisen technisch bedingt relativ geringe Signal-und Kontrast-zu-Rausch-Verhältnisse (SNR und CNR) auf, sodass die Durchführung der Herzbildgebung bei 3 T anstelle der etablierteren 1,5 T sehr vielversprechend erscheint [77,78]. Die zunehmende Magnetfeldstärke bringt aber auch Effekte wie einen stärkeren magnetohydrodynamischen Effekt im EKG, geänderte magnetische Relaxationszeiten, geänderten "Chemical Shift", vermehrte Inhomogenitäten des anregenden Hochfrequenzfelds, höhere spezifische Absorptionsraten (SAR) bei gleichen Sequenzparametern und schlussendlich größere Magnetfeldinhomogenitäten mit sich [77,78]. Besonders drastisch ist diese Situation bei der Steady-State-Free-Precession-Sequenz (SSFP), für deren Anwendung bei 3 T verbesserte Shim-Prozeduren [79,80] und/oder eine über Scouting zu bestimmende Optimierung der Resonanzfrequenz [81] verwendet werden müssen, um Banding-Artefakte zu vermeiden.…”

Section: Tesla-mrt In Der Herzbildgebungunclassified

Klinischer Stellenwert und Indikationen zur Magnetresonanztomografie des Herzens 2013: Ein interdisziplinäres Expertenstatement

Hergan

Globits²,

Schuchlenz

et al. 2013

Fortschr Röntgenstr

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Zusammenfassung Obwohl in den letzten Jahren wissenschaftlich weitere Indikationen f?r die Magnetresonanztomografie (MRT) des Herzens erarbeitet wurden, hat sich die Akzeptanz dieser Untersuchungstechnik in Klinik und Praxis bei den Kardiologen und Radiologen nicht mit der gleichen Geschwindigkeit entwickelt wie die diagnostischen M?glichkeiten. Verantwortlich daf?r sind unter anderem die notwendige kostspielige Ausstattung, die relativ lange Untersuchungszeit, das hohe Ma? an technischem Wissen und nicht zuletzt die fehlende oder unzureichende Remuneration. Dar?ber hinaus sind ein Festhalten an traditionellen Abkl?rungsalgorithmen, ein limitierter Zugang zu dieser Technologie sowie Probleme in der f?cher?bergreifenden Kooperation zu beobachten. Die seit vielen Jahren bestehende interdisziplin?re Kooperation hat die Aufgabe, einen substanziellen Beitrag zur ?berwindung der genannten Problemfelder zu leisten und die MRT des Herzens in das Abkl?rungsspektrum kardialer Erkrankungen als fixen Bestandteil zu integrieren. Eine kontinuierliche Verbesserung der Behandlung von Patienten mittels kosteneffizienter Diagnostik und Therapie hat hierbei h?chste Priorit?t. Die MRT des Herzens spielt dabei eine bedeutende Rolle.

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Cardiovascular magnetic resonance at 3.0T: Current state of the art

Cited by 79 publications

References 92 publications

Italian registry of cardiac magnetic resonance

Italian registry of cardiac magnetic resonance

Diagnostic Accuracy of Three Different Protocols for 3.0T Coronary Magnetic Resonance Angiography

Klinischer Stellenwert und Indikationen zur Magnetresonanztomografie des Herzens 2013: Ein interdisziplinäres Expertenstatement

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