Patency of coronary bypass grafts: assessment with breath-hold contrast-enhanced MR angiography--value of a non-electrocardiographically triggered technique.

Wintersperger, Bernd J.; Engelmann, Markus G.; Smekal, Alexander; Knez, Andreas; Penzkofer, H.; Höfling, B.; Laub, G.; Reiser, MF

doi:10.1148/radiology.208.2.9680557

Cited by 88 publications

(29 citation statements)

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“…Additionally, both 3D noncontrast 64 and contrast-enhanced coronary MRA have been used for assessment of graft patency, 65,66 with slightly improved results. The accuracy of ECG-gated SSFP sequences appears to be similar to that of spin-echo and gradient-echo approaches.…”

Section: Coronary Mra For Coronary Artery Bypass Graft Assessmentmentioning

confidence: 99%

Noninvasive Coronary Artery Imaging

Bluemke¹,

Achenbach²,

Budoff³

et al. 2008

Circulation

414

122

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Section: Coronary Mra For Coronary Artery Bypass Graft Assessmentmentioning

confidence: 99%

Noninvasive Coronary Artery Imaging

Bluemke¹,

Achenbach²,

Budoff³

et al. 2008

Circulation

414

122

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“…While the patency and stenosis of coronary artery bypass grafts can be assessed reliably with conventional X-ray angiography, this technique is invasive and involves some risk. MRI has been shown to be useful for demonstrating the occlusion of coronary artery bypass graft with the use of spin-echo MRI (sensitivity/specificity of 90%/72%) (70), cine MRI (88%/ 100%) (71), and CE 3D MRA (95%/81%) (72). Recently Bunce et al (72) evaluated the accuracy of SSFP multislice MR images and CE 3D MRA for the detection of coronary artery bypass patency in 25 patients.…”

Section: Mr Of Coronary Artery Bypass Graftmentioning

confidence: 99%

“…MRI has been shown to be useful for demonstrating the occlusion of coronary artery bypass graft with the use of spin-echo MRI (sensitivity/specificity of 90%/72%) (70), cine MRI (88%/ 100%) (71), and CE 3D MRA (95%/81%) (72). Recently Bunce et al (72) evaluated the accuracy of SSFP multislice MR images and CE 3D MRA for the detection of coronary artery bypass patency in 25 patients. Although the sensitivity values of steady-state MRA and CE-MRA were similar (84% vs. 85%), SSFP MRI resulted in more false-positive findings for occlusions and reduced visualization of the arterial grafts.…”

Section: Mr Of Coronary Artery Bypass Graftmentioning

confidence: 99%

Magnetic resonance imaging for ischemic heart disease

Sakuma

2007

Magnetic Resonance Imaging

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Cardiac MRI has long been recognized as an accurate and reliable means of evaluating cardiac anatomy and ventricular function. Considerable progress has been made in the field of cardiac MRI, and cardiac MRI can provide accurate evaluation of myocardial ischemia and infarction (MI). Late gadolinium (Gd)-enhanced MRI can clearly delineate subendocardial infarction, and the assessment of transmural extent of infarction on late enhanced MRI has been shown to be useful in predicting functional recovery of dysfunctional myocardium in patients after MI. Stress first-pass contrast-enhanced (CE) myocardial perfusion MRI can be used to detect subendocardial ischemia, and recent studies have demonstrated the high diagnostic accuracy of stress myocardial perfusion MRI for detecting significant coronary artery disease (CAD). Free-breathing, whole-heart coronary MR angiography (MRA) was recently introduced as a method that can provide visualization of all three major coronary arteries within a single three-dimensional (3D) acquisition. With further improvements in MRI techniques and the establishment of a standardized study protocol, cardiac MRI will play a pivotal role in managing patients with ischemic heart disease.

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“…More recently, 3-D MR angiography techniques, such as gadolinium-enhanced breath-hold MR angiography sequence and navigator-gated MR angiography with 1-mm resolution, proved to be feasible in assessing graft patency over a longer course. 7,8,22 The overall sensitivity and specificity of these techniques in detecting patent grafts varied from 88% to 98% and 72% to 100%, respectively. In the present study, we applied a technically improved highresolution MR angiography sequence, which allowed the identification of vein graft occlusion with an at least as good sensitivity (83%) and specificity (98% to 100%) as previously obtained values with lower spatial resolution.…”

Section: Previous Experience In Mr Angiography Of Graftsmentioning

confidence: 99%

“…Previous 2-dimensional (2-D) spin-echo and gradient-echo MR techniques, 4 -6 3-dimensional (3-D) breath-hold contrastenhanced MR angiography techniques, 7,8 and volume coronary angiography using targeted scans (VCATS) 9 have enabled the evaluation of graft patency and could only differentiate between graft patency and occlusion. The assessment of vein graft disease has remained a problem.…”

mentioning

confidence: 99%

Detection of Vein Graft Disease Using High-Resolution Magnetic Resonance Angiography

et al. 2002

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Background-The application of previous magnetic resonance (MR) angiography techniques has enabled noninvasive differentiation between patent and occluded coronary artery bypass grafts. However, the detection of graft stenosis remains difficult. The purpose of our study was to determine the accuracy of high-resolution navigator-gated 3-dimensional (3-D) MR angiography in detecting vein graft disease. Methods and Results-MR angiography was performed in addition to coronary angiography with quantitative coronary analysis in 56 vein grafts from 38 patients (mean age 66.6Ϯ9.3 years), who presented with recurrent chest pain after bypass surgery. Eighteen grafts showed a luminal stenosis Ն50%, 11 grafts a stenosis Ն70%, and 6 grafts were occluded. All MR angiograms were evaluated independently by 2 blinded observers, who scored the presence of graft occlusion and graft stenosis Ն50% and Ն70% with a confidence level of 1 to 10. MR image quality was judged as insufficient in 6 grafts and these were excluded. Receiver-operator characteristic analysis revealed an area under the curve of 0.89 and 0.89 for identifying graft occlusion, 0.81 and 0.87 for stenosis Ն50%, and 0.82 and 0.79 for stenosis Ն70% for the 2 observers, respectively. Interobserver agreement in assessing graft occlusion and stenosis Ն50% and Ն70% was 94% (ϭ0.74, rϭ0.81), 72% (ϭ0.40, rϭ0.66), and 82% (ϭ0.53, rϭ0.72)

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Patency of coronary bypass grafts: assessment with breath-hold contrast-enhanced MR angiography--value of a non-electrocardiographically triggered technique.

Abstract: Non-electrocardiographically triggered contrast-enhanced MR angiography allows reliable assessment of the patency of venous and arterial coronary bypass grafts.

Cited by 88 publications

References 0 publications

Noninvasive Coronary Artery Imaging

Noninvasive Coronary Artery Imaging

Magnetic resonance imaging for ischemic heart disease

Detection of Vein Graft Disease Using High-Resolution Magnetic Resonance Angiography

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