Detection of coronary stenoses on source and projection images using three-dimensional MR angiography with retrospective respiratory gating: preliminary experience.

Woodard, Pamela K.; Li, Debiao; Haacke, E. Mark; Dhawale, P.J.; Kaushikkar, S; Barzilai, Benico; Braverman, Alan C.; Ludbrook, Philip A.; Weiss, Alan N.; Brown, Jeffrey J.; Mirowitz, Scott A.; Pilgram, Thomas K.; Gutiérrez, Fernando R.

doi:10.2214/ajr.170.4.9530027

Cited by 91 publications

(37 citation statements)

References 18 publications

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“…4 Serial evaluation with x-ray angiography carries risks associated with its invasive nature and exposure to ionizing radiation, and is more expensive. 5 Non-invasive coronary magnetic resonance angiography (MRA) has previously been shown to be useful in the diagnosis of anomalous origin of the coronary arteries, 6,7 native coronary artery disease, 8,9 and coronary bypass graft patency. 10 Reports on the use of current coronary MRA techniques in Kawasaki disease have been limited to 1 or 2 patients, often without comparison to x-ray angiography.…”

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Coronary Magnetic Resonance Angiography in Adolescents and Young Adults With Kawasaki Disease

et al. 2002

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Background — In patients with Kawasaki disease, serial evaluation of the distribution and size of coronary artery aneurysms (CAA) is necessary for risk stratification and therapeutic management. Although transthoracic echocardiography is often sufficient for this purpose initially, visualization of the coronary arteries becomes progressively more difficult as children grow. We sought to prospectively compare coronary magnetic resonance angiography (MRA) and x-ray coronary angiography findings in patients with CAA caused by Kawasaki disease. Methods and Results — Six subjects (age 10 to 25 years) with known CAA from Kawasaki disease underwent coronary MRA using a free-breathing T2-prepared 3D bright blood segmented k-space gradient echo sequence with navigator gating and tracking. All patients underwent x-ray coronary angiography within a median of 75 days (range, 1 to 359 days) of coronary MRA. There was complete agreement between MRA and x-ray angiography in the detection of CAA (n=11), coronary artery stenoses (n=2), and coronary occlusions (n=2). Excellent agreement was found between the 2 techniques for detection of CAA maximal diameter (mean difference=0.4±0.6 mm) and length (mean difference=1.4±1.6 mm). The 2 methods showed very similar results for proximal coronary artery diameter (mean difference=0.2±0.5 mm) and CAA distance from the ostia (mean difference=0.1±1.5 mm). Conclusion — Free-breathing 3D coronary MRA accurately defines CAA in patients with Kawasaki disease. This technique may provide a non-invasive alternative when transthoracic echocardiography image quality is insufficient, thereby reducing the need for serial x-ray coronary angiography in this patient group.

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confidence: 99%

Coronary Magnetic Resonance Angiography in Adolescents and Young Adults With Kawasaki Disease

et al. 2002

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“…Thus, by orienting the threedimensional (3D) imaging slab along the major axis of the coronary vessels, coronary coverage can be more optimal with smaller imaging volumes (16). Recently, some investigators have used axial orientations for the left main trunk (LMT), proximal and mid left anterior descending artery (LAD), and proximal left circumflex artery (LCX), and oblique orientations for the right coronary artery (RCA) (17,18). However, two double-oblique scan volumes, when oriented along the atrioventricular sulcus for the RCA-LCX group and the interventricular sulcus for the LMT-LAD group, could include more distal coronary segments, as well as proximal and mid arterial segments.…”

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confidence: 99%

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

Watanabe

Nagayama

Amoh

et al. 2002

Magnetic Resonance Imaging

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Purpose:To investigate the feasibility of high-resolution selective three-dimensional (3D) magnetic resonance coronary angiography (MRCA) in the evaluation of coronary artery stenoses. Materials and Methods:In 12 patients with coronary artery stenoses, MRCA of the coronary artery groups, including the coronary segments with stenoses of 50% or greater based on conventional x-ray coronary angiography (CAG), was performed with double-oblique imaging planes by orienting the 3D slab along the major axis of each right coronary artery-left circumflex artery (RCA-LCX) group and each left main trunk-left anterior descending artery (LMT-LAD) group. Ten RCA-LCX and five LMT-LAD MR angiograms were obtained, and the results were compared with those of conventional x-ray angiography.Results: Among 70 coronary artery segments expected to be covered, a total of 49 (70%) segments were fully demonstrated in diagnostic quality. The identification of segmental location of stenoses showed as high an accuracy as 96%. The retrospective analysis for stenosis of 50% or greater yielded the sensitivity, specificity, and accuracy of 80%, 85%, and 84%, respectively. Conclusion:Selective 3D MRCA has the potential for segment-by-segment evaluation of major portions of the right and left coronary arteries with high accuracy. THE DESIRE TO REPLACE CONVENTIONAL x-ray coronary angiography (CAG) by a less invasive imaging method is commonplace. Magnetic resonance coronary angiography (MRCA) has been evaluated by many authors since the late 1980s (1-16). 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. 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. If all of the coronary arteries are covered with the transaxial imaging plane (12)(13)(14), the imaging time would be prolonged in association with large volume acquisition, and the right coronary artery could not be obtained with high spatial resolution because it runs in the through-plane direction. Thus, by orienting the threedimensional (3D) imaging slab along the major axis of the coronary vessels, coronary coverage can be more optimal with smaller imaging volumes (16). Recently, some investigators have used axial orientations for the left main trunk (LMT), proximal and mid left anterior descending artery (LAD), and proximal left circumflex artery (LCX), and oblique orientations for the right coronary artery (RCA) (17,18). However, two double-oblique scan volumes, when oriented along the atrioventri...

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“…The use of CMR coronary angiography for native vessel integrity has been shown to be feasible, especially for the proximal and mid-portions of the major coronary vessels, but it remains technically demanding in the branch vessels owing to their smaller size, tortuosity, complex 3D anatomy, and cardiac and respiratory motion artifacts (9,37,38). Using current 3D acquisitions and optimized sequences, good results for the exclusion of multivessel disease have been shown.…”

Section: Post-processing and Data Analysismentioning

confidence: 99%

ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance

Budoff¹,

Cohen²,

García³

et al. 2005

Circulation

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Detection of coronary stenoses on source and projection images using three-dimensional MR angiography with retrospective respiratory gating: preliminary experience.

Cited by 91 publications

References 18 publications

Coronary Magnetic Resonance Angiography in Adolescents and Young Adults With Kawasaki Disease

Coronary Magnetic Resonance Angiography in Adolescents and Young Adults With Kawasaki Disease

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

ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance

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