Value of Fast Gradient Echo Magnetic Resonance Angiography as an Adjunct to Coronary Arteriography in Detecting and Confirming the Course of Clinically Significant Coronary Artery Anomalies

Vliegen, Hubert W.; Doornbos, Joost; Roos, Albert de; Jukema, J. Wouter; Bekedam, Martijn A.; Wall, Ernst E. van der

doi:10.1016/s0002-9149(96)00866-1

Cited by 129 publications

(44 citation statements)

References 6 publications

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“…190 -192 In many studies, coronary MRA has been found to be superior to CA because it has identified prior misclassification (by CA) of anomalous vessels. 190,192 These data strongly support a clinical role for coronary MRA as a noninvasive tool for defining the anatomic course in patients with known or suspected anomalous coronary vessels. Although coronary MRA is sufficiently advanced to allow for definition of anomalous coronary vessels, the data do not support a general role for identification of native vessel stenoses.…”

Section: Yucel Et Al Magnetic Resonance Angiographymentioning

confidence: 83%

Magnetic Resonance Angiography

Yucel¹,

Anderson²,

Edelman³

et al. 1999

Circulation

126

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Section: Yucel Et Al Magnetic Resonance Angiographymentioning

confidence: 83%

Magnetic Resonance Angiography

Yucel¹,

Anderson²,

Edelman³

et al. 1999

Circulation

126

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“…In fact, MR coronary angiography has been reported to be clinically relevant in determining the origin and course of anomalous coronary arteries [19][20][21] for the follow-up of coronary artery bypass graft patencies [7,22] and in donor-recipient anastomoses for heart transplantation [23,24]. Nevertheless, the precise role of MR coronary angiography in depicting coronary artery atheromatosis and coronary artery stenosis must be still identified, although recent results have shown that MR coronary angiography is promising in detecting stenotic coronary artery lesions at the proximal and middle part of the vessels.…”

Section: Discussionmentioning

confidence: 99%

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Giorgi

Dymarkowski

Maes

et al. 2002

American Journal of Roentgenology

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OBJECTIVE. The goal of our study was to evaluate a new three-dimensional real-time navigator MR coronary angiography sequence to noninvasively visualize the coronary arteries.SUBJECTS AND METHODS. Fifteen healthy volunteers underwent MR coronary angiography with a new balanced turbo field-echo sequence in comparison with the standard turbo field-echo sequence. Signal-to-noise, blood-to-myocardium, blood-to-fat, and blood-topericardial fluid contrast ratios of the left and right coronary artery systems were measured. Image quality was graded, the length and diameter of the coronary arteries were measured, and the number of visible side branches was assessed.RESULTS. The balanced turbo field-echo images yielded a higher blood-to-myocardium and blood-to-pericardial fluid contrast ratio, a similar blood-to-fat contrast ratio, and a lower signal-to-noise ratio than the turbo field-echo images. On a 5-point grading scale (1, nondiagnostic or unreadable; 2, poor; 3, moderate; 4, good; 5, excellent), image quality was rated significantly better for the balanced turbo field-echo sequence than for the turbo field-echo sequence (left coronary artery, 4.0 ± 0.6 vs 3.6 ± 0.5 [ p = 0.015]; right coronary artery, 4.4 ± 0.4 vs 3.6 ± 0.4 [ p < 0.0001], respectively), resulting in a significantly longer segment of the three major coronary arteries visualized (left anterior descending coronary artery, 92 ± 21 mm vs 79 ± 24 mm; left circumflex coronary artery, 70 ± 7 mm vs 60 ± 18 mm; right coronary artery, 112 ± 28 mm vs 95 ± 27 mm) and a significantly higher number of side branches visualized (left anterior descending coronary artery, 2.9 ± 1.3 vs 1.5 ± 1.3; left circumflex coronary artery, 2.1 ± 1.7 vs 1.0 ± 1.2; right coronary artery, 3.7 ± 1.7 vs 2.6 ± 1.5). Mean imaging time per coronary artery was significantly shorter for the balanced turbo field-echo sequence (5.7 ± 1.0 min) than for the turbo field-echo sequence (8.4 ± 1.4 min) ( p < 0.0001).CONCLUSION. Compared with standard turbo field-echo MR coronary angiography, optimized balanced turbo field-echo MR coronary angiography improves the visualization of the coronary arteries and their side branches within a significantly shorter imaging time.oronary artery disease remains one of the leading causes of morbidity and mortality in the industrialized countries. Catheter angiography, currently the gold standard in detecting atheromatous coronary artery disease, is invasive and potentially harmful and necessitates the use of iodinated contrast material and radiation. Therefore, several techniques are under research to depict atheromatous changes in the coronary arteries in a noninvasive or less invasive fashion [1,2]. This technique could be used to screen or select patients for coronary catherization, which would significantly reduce the number of unnecessary diagnostic catherizations and would thus be potentially cost-effective. Three-dimensional (3D) MR coronary angiography techniques, performed either in breath-hold [3][4][5] or during free-breathing using a navigator [6,7...

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“…10 -12 However, only 1 subject with congenital heart disease has been included in studies to date. 12 Breath holding can be difficult for subjects with congenital heart disease secondary to the underlying cardiac condition or associated skeletal abnormalities. It has become possible to monitor the position of the diaphragm with an intrinsic MR sequence known as a navigator echo (NE).…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Imaging in Grown Up Congenital Heart Disease

et al. 2000

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Background-There is a high incidence of anomalous coronary arteries in subjects with congenital heart disease. These abnormalities can be responsible for myocardial ischemia and sudden death or be damaged during surgical intervention. It can be difficult to define the proximal course of anomalous coronary arteries with the use of conventional x-ray coronary angiography. Magnetic resonance coronary angiography (MRCA) has been shown to be useful in the assessment of the 3-dimensional relationship between the coronary arteries and the great vessels in subjects with normal cardiac morphology but has not been used in patients with congenital heart disease. Methods and Results-Twenty-five adults with various congenital heart abnormalities were studied. X-ray coronary angiography and respiratory-gated MRCA were performed in all subjects. Coronary artery origin and proximal course were assessed for each imaging modality by separate, blinded investigators. Images were then compared, and a consensus diagnosis was reached. With the consensus readings for both magnetic resonance and x-ray coronary angiography, it was possible to identify the origin and course of the proximal coronary arteries in all 25 subjects: 16 with coronary anomalies and 9 with normal coronary arteries. Respiratory-gated MRCA had an accuracy of 92%, a sensitivity of 88%, and a specificity of 100% for the detection of abnormal coronary arteries. The MRCA results were more likely to agree with the consensus for definition of the proximal course of the coronary arteries (PϽ0.02). Conclusions-For the assessment of anomalous coronary artery anatomy in patients with congenital heart disease, the use of the combination of MRCA with x-ray coronary angiography improves the definition of the proximal coronary artery course. MRCA provides correct spatial relationships, whereas x-ray angiography provides a view of the entire coronary length and its peripheral run-off. Furthermore, respiratory-gated MRCA can be performed without breath holding and with only limited subject cooperation.

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Value of Fast Gradient Echo Magnetic Resonance Angiography as an Adjunct to Coronary Arteriography in Detecting and Confirming the Course of Clinically Significant Coronary Artery Anomalies

Cited by 129 publications

References 6 publications

Magnetic Resonance Angiography

Magnetic Resonance Angiography

Improved Visualization of Coronary Arteries Using a New Three-Dimensional Submillimeter MR Coronary Angiography Sequence with Balanced Gradients

Coronary Artery Imaging in Grown Up Congenital Heart Disease

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