Hochauflösende 3D-MR-Koronarangiographie inEcht-Zeit-Navigatortechnik: Ergebnisse aus107 Patientenuntersuchungen

Sommer, Torsten; Hofer, U; Hackenbroch, M. H.; Meyer, Connie; Flacke, Sebastian; Schmiedel, A; Schmitz, C; Thiemann, Kl. J.; Omran, Heyder; Schild, H

doi:10.1055/s-2002-25121

Cited by 37 publications

(6 citation statements)

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“…Viele Studien haben sich sowohl mit der Evaluation der Bildqualität als auch weitergehend mit der diagnostischen Aussagekraft beschäftigt. Unter den wichtigsten Arbeiten sind Kim et al mit einer Multicenterstudie und Sommer et al mit einer Singlecenterstudie [10,11]. Beide evaluierten eine 3D-Gradientenechosequenz bei freier Atmung und erzielten viel versprechende Ergebnisse hinsichtlich der Detektion von signifikanten Koronararterienstenosen.…”

Section: Introductionunclassified

Whole-Heart-MR-Koronarangiographie - erste Ergebnisse

Özgün

Hoffmeier²,

Quante³

et al. 2006

Fortschr Röntgenstr

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Section: Introductionunclassified

Whole-Heart-MR-Koronarangiographie - erste Ergebnisse

Özgün

Hoffmeier²,

Quante³

et al. 2006

Fortschr Röntgenstr

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“…3 Nur eine Subgruppe der Patienten erhielt eine konventionelle Koronarangiographie. 4 In diese Studien wurden (zwar in geringer Anzahl) jedoch auch Stents in vençsen koronaren Bypasses eingeschlossen. 5 Nur Stents im linken Hauptstamm wurden in diese Studien eingeschlossen.…”

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CT-Koronarangiografie: Untersuchungstechnik, klinische Ergebnisse und Ausblick in zukünftige Entwicklungen

Dewey

Hamm

2007

Fortschr Röntgenstr

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Multislice computed tomography (MSCT) after intravenous contrast agent administration enables visualization of the coronary arteries with high spatial resolution (voxel sizes down to 0.5 x 0.35 x 0.35 mm (3)) and a short scan time. Magnetic resonance imaging (MRI) is also intensively studied with respect to the noninvasive detection of coronary artery stenosis and thus the detection of coronary artery disease (CAD) without radiation exposure but is not equal to MSCT at present. This article provides an overview of the historical development of CT coronary angiography from 4-slice CT to 16-slice CT and 64-slice CT. A crucial aspect of this development is the improvement in image quality resulting from shorter breath-hold periods and the reduced gantry rotation time. Other techniques that appear to considerably improve image quality and accuracy and make CT independent of patient heart rates are multi-segment reconstruction and dual-source CT. Sublingual nitroglycerin as well as oral or intravenous betablocker administration should be considered in relation to the diagnostic question to be answered and the patient's heart rate. In the studies available CT coronary angiography with at least 12 simultaneous detector rows has a sensitivity of 96.9 % and a specificity of 75.3 % at the patient level. Especially the negative predictive value of CT (94.6 %) emphasizes the idea that this technique may reliably exclude CAD in patients with intermediate pretest likelihood. In the near future, 256-slice CT will allow examination of the entire heart during one heartbeat or even 4D CT scanning with simultaneous assessment of myocardial perfusion. Automatic or semiautomatic software tools will assume a central place in detecting and quantifying coronary artery stenoses and plaques as well as in the analysis of cardiac function in the clinical setting over the next years. Prior to its routine clinical use, the cost-effectiveness of CT coronary angiography must be determined and the clinical role of MSCT must be investigated in multi-center studies including different patient populations.

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“…Coronary magnetic resonance angiography (CMRA) has been proven to be of clinical value for assessing congenital coronary artery anomalies (1, 2), and its potential for noninvasively detecting coronary artery disease has been demonstrated (3, 4). However, routine clinical CMRA remains technically challenging due to small vessel size, adjacent fat, and myocardium and vessel tortuosity (5).…”

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confidence: 99%

“…Respiratory motion has been addressed with the use of two main strategies: 1) free breathing using navigator‐echo‐based respiratory gating (6–15), and 2) breath‐hold techniques (16–20). Navigated techniques are often combined with 3D acquisition methods, resulting in average scan times of 8–13 min (4, 12, 14). However, long scan times are associated with diaphragmatic drift, a phenomenon that can inadvertently diminish navigator efficiency (8).…”

mentioning

confidence: 99%

“…However, long scan times are associated with diaphragmatic drift, a phenomenon that can inadvertently diminish navigator efficiency (8). With reduced navigator efficiency, further degradation in image quality may result as scan times can lengthen toward a 30‐min acquisition (4). Although one can improve the diminished navigator efficiency by increasing the acceptance window or readjusting the navigator volume, average scan times of up to 49 ± 19 min have been reported for imaging both the right and left coronary arteries (4).…”

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confidence: 99%

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Short breath‐hold, volumetric coronary MR angiography employing steady‐state free precession in conjunction with parallel imaging

Niendorf

Saranathan

Lingamneni³

et al. 2005

Magnetic Resonance in Med

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An ECG-gated, 3D steady-state free precession (SSFP) technique in conjunction with sensitivity encoding (SENSE)-based parallel imaging was implemented for short breath-hold, volumetric coronary MR angiograpy (CMRA). Two parallel imaging acquisition strategies (employing 1 R-R and 2 R-R intervals, respectively) were developed to achieve 1) very short breathhold times (12 s for a heart rate of 60 bpm), and 2) small acquisition windows to minimize sensitivity to physiologic motion. Both strategies were examined in CMRA applications over a range of heart rates. A four-point scale blinded reading (with 4 indicating the most desirable features) revealed substantial image quality improvements for the accelerated data as compared to the nonaccelerated approach. The 1 R-R interval scheme yielded an image score of 3.39 ؎ 0.60, and was found to be particularly suitable for low heart rates (P ‫؍‬ 0.0008). The 2 R-R interval strategy yielded an image score of 3.35 ؎ 0.64, and was more appropriate for higher heart rates (P ‫؍‬ 0.03). The results demonstrate that 3D SSFP combined with parallel imaging is a versatile method for short breath-hold CMRA while maintaining high spatial resolution. This strategy permits imaging of the major coronary artery distributions in two to three breath-holds using targeted slabs, and offers the potential for Coronary magnetic resonance angiography (CMRA) has been proven to be of clinical value for assessing congenital coronary artery anomalies (1,2), and its potential for noninvasivelydetectingcoronaryarterydiseasehasbeendemonstrated (3,4). However, routine clinical CMRA remains technically challenging due to small vessel size, adjacent fat, and myocardium and vessel tortuosity (5). Furthermore, respiratory and cardiac motion can degrade image quality, particularly when motion suppression techniques are unavailable, unsuccessful, or not utilized.Various approaches have been proposed to minimize artifacts from respiratory and cardiac motion. Cardiac motion has been effectively dealt with by electrocardiograph (ECG) gating and by restricting the data acquisition period to the mid-diastolic phase, during which heart motion is minimal. Respiratory motion has been addressed with the use of two main strategies: 1) free breathing using navigator-echo-based respiratory gating (6 -15), and 2) breathhold techniques (16 -20). Navigated techniques are often combined with 3D acquisition methods, resulting in average scan times of 8 -13 min (4,12,14). However, long scan times are associated with diaphragmatic drift, a phenomenon that can inadvertently diminish navigator efficiency (8). With reduced navigator efficiency, further degradation in image quality may result as scan times can lengthen toward a 30-min acquisition (4). Although one can improve the diminished navigator efficiency by increasing the acceptance window or readjusting the navigator volume, average scan times of up to 49 Ϯ 19 min have been reported for imaging both the right and left coronary arteries (4). Consequently, navigator techniques...

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Hochauflösende 3D-MR-Koronarangiographie inEcht-Zeit-Navigatortechnik: Ergebnisse aus107 Patientenuntersuchungen

Cited by 37 publications

References 0 publications

Whole-Heart-MR-Koronarangiographie - erste Ergebnisse

Whole-Heart-MR-Koronarangiographie - erste Ergebnisse

CT-Koronarangiografie: Untersuchungstechnik, klinische Ergebnisse und Ausblick in zukünftige Entwicklungen

Short breath‐hold, volumetric coronary MR angiography employing steady‐state free precession in conjunction with parallel imaging

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