Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0-T

Yang, Qi; Li, Kuncheng; Liu, Xin; Bi, Xiaoming; Liu, Zhi; An, Jing; Zhang, Al; Jerec̆ić, Renate; Li, Debiao

doi:10.1016/j.jacc.2009.03.016

Cited by 171 publications

(98 citation statements)

References 24 publications

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“…Assessable segments had image quality of ≥ 2, 9,12) and estimated assessable proximal segments were segments 1, 2, 3, 5, 6, and 11, and had an image quality of ≥ 2. Statistical analysis: Data are reported as the mean ± standard deviation.…”

Section: Methodsmentioning

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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Section: Methodsmentioning

confidence: 99%

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

et al. 2016

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“…In recent years, magnetic resonance imaging (MRI) and CT have emerged as the most promising non‐invasive imaging techniques in the primary diagnosis of CAD and HF. While a meta‐analysis published in 2010 suggested that CT was superior to MRI, recent studies directly comparing CT and MRI or X‐ray coronary angiography and MRI indicated that there was no significant difference when assessing presence or absence of >50% coronary artery stenosis 19, 20, 21, 22. For the visualization of myocardial ischaemia in HF, CMR was demonstrated to be superior to single‐photon emission CT in a large prospective trial with 752 recruited patients 9.…”

Section: Numbersmentioning

confidence: 99%

Magnetic resonance imaging in heart failure, including coronary imaging: numbers, facts, and challenges

et al. 2017

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Coronary artery disease (CAD) is a major risk factor for the incidence and progression of heart failure (HF). HF is characterized by a substantial morbidity and mortality and its lifetime risk is estimated at approximately 20% for men and women. As patients are in most cases identified only after developing overt clinical symptoms, detecting early stages of CAD and HF is of paramount importance. Due to its non‐invasiveness, excellent soft‐tissue contrast, high spatial resolution, and multiparametric nature, cardiovascular magnetic resonance (CMR) imaging has emerged as a promising radiation‐free technique to assess a wide range of cardiovascular diseases such as CAD or HF, enabling a comprehensive evaluation of myocardial anatomy, regional and global function, and viability with the additional benefit of in vivo tissue characterization. CMR has the potential to enhance our understanding of coronary atherosclerosis and the aetiology of HF on functional and biological levels, to identify patients at risk for CAD or HF, and to enable individualized patient management and improved outcomes. Even though larger‐scale studies on the different applications of CMR for the assessment of heart failure are scarce, recent research highlighted new possible clinical applications for CMR in the evaluation of CAD and HF.

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“…High-field-strength 3.0-T systems improve the signal-to-noise ratio of coronary MR angiography, such that diagnostic accuracy of 3.0-T contrast-enhanced imaging approaches that of some coronary CTA systems (35). However administration of contrast is not without risks, such as the potential for nephrogenic systemic fibrosis in patients with severe renal dysfunction who receive gadolinium agents, resulting in a recent FDA advisory.…”

Section: Magnetic Resonance Imaging (Mri)mentioning

confidence: 99%

Therapeutic modulation of the natural history of coronary atherosclerosis: lessons learned from serial imaging studies

Andrews¹,

Puri²,

Kataoka³

et al. 2016

Cardiovasc. Diagn. Ther.

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Despite advances in risk prediction, preventive and therapeutic strategies, atherosclerotic cardiovascular disease remains a major public health challenge worldwide, carrying considerable morbidity, mortality and health economic burden. There continues to be a need to better understand the natural history of this disease to guide the development of more effective treatment, integral to which is the rapidly evolving field of coronary artery imaging. Various imaging modalities have been refined to enable detailed visualization of the pathological substrate of atherosclerosis, providing accurate and reproducible measures of coronary plaque burden and composition, including the presence of high-risk characteristics. The serial application of such techniques, including coronary computed tomography angiography (CTA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have uncovered important insights into the progression of coronary plaque over time in patients with stable and unstable coronary artery disease (CAD), and its responsiveness to therapeutic interventions. Here we review the use of different imaging modalities for the surveillance of coronary atherosclerosis and the lessons they have provided about the modulation of CAD by both traditional and experimental therapies.

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Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0-T

Cited by 171 publications

References 24 publications

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

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

Magnetic resonance imaging in heart failure, including coronary imaging: numbers, facts, and challenges

Therapeutic modulation of the natural history of coronary atherosclerosis: lessons learned from serial imaging studies

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