Feasibility of coronary artery wall thickening assessment in asymptomatic coronary artery disease using phase-sensitive dual-inversion recovery MRI at 3T

Abstract

Objectives The purpose of this study is to (1) investigate the image quality of phase-sensitive dual inversion recovery (PS-DIR) coronary wall imaging in healthy subjects and in subjects with known coronary artery disease (CAD) and to (2) investigate the utilization of PS-DIR at 3T in the assessment of coronary artery thickening in subjects with asymptomatic but variable degrees of CAD. Materials and Methods A total of 37 subjects participated in this Institutional Review Board approved and HIPAA-compliant study. These included 21 subjects with known CAD as identified on Multi-Detector CT angiography (MDCT). Sixteen healthy subjects without known history of CAD were included. All subjects were scanned using free-breathing PS-DIR MRI for the assessment of coronary wall thickness at 3T. Lumen-tissue contrast-to-noise ratio (CNR), signal-to-noise (SNR), and quantitative vessel parameters including lumen area and wall thickness were measured. Statistical analyses were performed. Results PS-DIR was successfully completed in 76% of patients and in 88% of the healthy subjects. Phase-sensitive signed magnitude reconstruction, compared to modulus magnitude images, significantly improved lumen-tissue contrast-to-noise ratio (CNR) in both healthy subjects (26.73±11.95 vs. 14.65±9.57, p<0.001) and in patients (21.45±7.61 vs. 16.65±5.85, p<0.001). There was no difference in image CNR and SNR between groups. In arterial segments free of plaques, coronary wall was thicker in patients in comparison to healthy subjects (1.74±0.27mm vs. 1.17±0.14mm, p<0.001) without a change in lumen area (4.51±2.42 mm2 vs. 5.71±3.11 mm2, p=0.25). Conclusions This is the first study to demonstrate the feasibility of successfully obtaining vessel wall images at 3T using PS-DIR in asymptomatic patients with known variable degrees of CAD as detected by MDCT. This was achieved with a fixed subject-invariant planning of blood signal nulling. With that limitation alleviated, PS-DIR coronary wall MRI is capable of detecting arterial thickening and positive arterial remodeling at 3T in asymptomatic CAD.

Coronary artery wall imaging

“…ECG gating at 3T has since been improved by using a vector‐ECG and more advanced R‐wave detection algorithms, and fat suppression has been improved by using adiabatic pulses which are less sensitive to field inhomogeneities. A 2D spiral technique with phase‐sensitive dual inversion recovery has been used to image both healthy subjects and asymptomatic patients with known variable degrees of CAD at 3T . Imaging was successful in 88% of healthy subjects and in 76% of patients and showed arterial wall thickening and positive arterial remodeling in patients compared with healthy subjects.…”

Golden angle dual‐inversion recovery acquisition coupled with a flexible time‐resolved sparse reconstruction facilitates sequence timing in high‐resolution coronary vessel wall MRI at 3 T

“…This may affect the utility in patients. However, an extension with navigator approaches may enable both free‐breathing data acquisition and an extension with a retrospective selection of the acquisition window parameters. (Restrictions to the width of the acquisition window would apply, as not only cardiac but also respiratory motion would be among the confounders.)…”

Coronary atherosclerosis and dilation in hyper IgE syndrome patients: Depiction by magnetic resonance vessel wall imaging and pathological correlation

“…These imaging datasets were obtained in the proximal RCA segment, 1–3 cm distal to the vessel origin, at a location without noticeable stenosis or atherosclerotic disease on the coronary MRA image as previously described [10,11,13,14]. Data were acquired using a segmented k-space spiral acquisition (20 interleaves, acquisition window = 20 ms, α = 45°) with spectral spatial excitation [19], using a 32-channel phased array cardiac received coil and VCG triggering [20].…”

“…This technique is also more automated, with a high intraobserver, interobserver and interexperimentation reproducibility [11,13]. Additionally, the above are confirmed over a wide range of clinical coronary artery disease [10,13] without the use of radiation, intravenous contrast agents or beta-blockers needed for CTA. Finally, although the vessel wall could be seen on CTA, this has been primarily performed by MRI [10–15] because of the better contrast between the vessel wall and suppressed luminal blood signal, as well as suppressed pericardial fat signal surrounding the vessel utilizing dual-inversion techniques; thus resulting in an enhanced ability to delineate the coronary vessel wall as the only positive signal contrasted against a suppressed lumen blood and outer fat signals on MRI.…”

“…Specifically, TRAPD-MRI has a high temporal resolution, does not require a breath hold, and is less sensitive to patient variations in heart rate [11]. This technique is also more automated, with a high intraobserver, interobserver and interexperimentation reproducibility [11,13]. Additionally, the above are confirmed over a wide range of clinical coronary artery disease [10,13] without the use of radiation, intravenous contrast agents or beta-blockers needed for CTA.…”