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Abstract

Background

Coronary artery magnetic resonance angiography (CMRA) is a robust tool for delineation of the coronary artery anatomy. In order to overcome the issue of visual delineation of the quietest heart phase, we implemented a new three-dimensional (3D) multi-phase whole-heart CMRA.

Purpose

To evaluate the 3D multi-phase whole-heart CMRA technique for depiction of the coronary arteries and simultaneous assessment of cardiac function.

Material and Methods

Ten healthy volunteers were included in a prospective study comprising 3D whole-heart CMRA with multiple-phase acquisition on 1.5-T MR. As a reference for coronary artery imaging, single-phase CMRA was performed. Furthermore, two-dimensional SSFP imaging was performed for functional assessment. Vessel sharpness (VS) was rated on a 5-point Likert scale (5 = best) and ventricular volumes were assessed in respective sequences.

Results

VS scores were rated higher in multi-phase compared to single-phase CMRA: mean VS of the RCA was 4.6 ± 0.52 in multi-phase and 3.6 ± 1.17 in single-phase CMRA (z = –2.232, P = 0.031). Mean VS of the LM was 4.2 ± 0.79 vs. 3.7 ± 0.82 (z = –2.236, P = 0.063), of the LCX was 3.8 ± 1.03 vs. 3.4 ± 1.01 (z = –1.265, P = 0.359), and of the LAD was 3.9 ± 0.59 vs. 3.9 ± 0.32 (z = 0, P = 1.00). In functional assessment, the mean difference between multi-phase CMRA and two-dimensional SSFP imaging for assessing the end-diastolic volume of the left ventricle (LV-EDV) was –0.38% (95% CI -2.41–1.64) and for the right ventricular EDV –0.28 (95% CI -3.51–2.96).

Conclusion

The 3D multi-phase CMRA approach allows a time efficient depiction of the coronary arteries and a coeval functional assessment, with an improved vessel sharpness of the coronaries.

Keywords

Magnetic resonance imaging coronary imaging whole-heart 3D multi-phase cardiac volumetric assessment

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References

Achenbach

Barkhausen

Beer

et al. Consensus recommendations of the German Radiology Society (DRG), the German Cardiac Society (DGK) and the German Society for Pediatric Cardiology (DGPK) on the use of cardiac imaging with computed tomography and magnetic resonance imaging. Fortschr Röntgenstr 2012; 184:345–368.

Weiss

Habermann

Lilje

et al. MRI of congenital heart disease in childhood. Fortschr Röntgenstr 2004; 176:191–199.

Taylor

Thorne

Rubens

et al. Coronary artery imaging in grown up congenital heart disease: complementary role of magnetic resonance and x-ray coronary angiography. Circulation 2000; 101:1670–1678.

Vliegen

Doornbos

de Roos

et al. 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. Am J Cardiol 1997; 79T:773–776.

Post

van Rossum

Bronzwaer

et al. Magnetic resonance angiography of anomalous coronary arteries. A new gold standard for delineating the proximal course? Circulation 1995; 92:3163–3171.

Greil

Seeger

Miller

et al. Coronary magnetic resonance angiography and vessel wall imaging in children with Kawasaki disease. Pediatr Radiol 2007; 37:666–673.

Mangold

Kramer

Franzen

et al. Detection of cardiovascular disease in elite athletes using cardiac magnetic resonance imaging. Fortschr Röntgenstr 2013; 185:1167–1174.

Carvalho

Silva

Rigby

et al. Angiographic diagnosis of anomalous coronary artery in tetralogy of Fallot. Br Hear J 1993; 70:75–78.

Dabizzi

Teodori

Barletta

et al. Associated coronary and cardiac anomalies in the tetralogy of Fallot. An angiographic study. Eur Hear J 1990; 11:692–704.

10.

Fratz

Schuhbaeck

Buchner

et al. Comparison of accuracy of axial slices versus short-axis slices for measuring ventricular volumes by cardiac magnetic resonance in patients with corrected tetralogy of Fallot. Am J Cardiol 2009; 103:1764–1769.

11.

Miller

Simonetti

Kramer

et al. MR Imaging of the heart with cine true fast imaging with steady-state precession: influence of spatial and temporal resolutions on left ventricular functional parameters. Radiology 2002; 223:263–269.

12.

Krumm

Keuler

Mangold

et al. Single-breath-hold evaluation of cardiac function with use of time-resolved parallel cardiac magnetic resonance. Texas Hear Inst J 2017; 44:252–259.

13.

Westlake

. Use of confidence intervals in analysis of comparative bioavailability trials. J Pharm Sci 1972; 61:1340–1341.

14.

Bender

Lange

Ziegler

. Multiple testing [German]. Dtsch Med Wochenschr 2007; 132 (Suppl.):e26–29.

15.

Krumm

Mueller

KAL

Klingel

et al. Cardiovascular magnetic resonance patterns of biopsy proven cardiac involvement in systemic sclerosis. J Cardiovasc Magn Reson 2016; 18:70.

16.

Landis

Koch

. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159–174.

17.

Johnson

Patel

Whigham

et al. Three-dimensional, time-resolved motion of the coronary arteries. J Cardiovasc Magn Reson 2004; 6:663–673.

18.

Scheffler

Heid

Hennig

. Magnetization preparation during the steady state: fat-saturated 3D TrueFISP. Magn Reson Med 2001; 45:1075–1080.

19.

Carr

. Whole-heart coronary magnetic resonance angiography at 3 Tesla in 5 minutes with slow infusion of Gd-BOPTA, a high-relaxivity clinical contrast agent. Magn Reson Med 2007; 58:1–7.

20.

Piccini

Monney

Sierro

et al. Respiratory self-navigated postcontrast whole-heart coronary MR angiography: initial experience in patients. Radiology 2014; 270:378–386.

21.

Sakuma

Ichikawa

Suzawa

et al. Assessment of coronary arteries with total study time of less than 30 minutes by using whole-heart coronary MR angiography. Radiology 2005; 237:316–321.

22.

Santos

Cunningham

Lustig

et al. Single breath-hold whole-heart MRA using variable-density spirals at 3T. Magn Reson Med 2006; 55:371–379.

23.

Weber

Martin

Higgins

. Whole-heart steady-state free precession coronary artery magnetic resonance angiography. Magn Reson Med 2003; 50:1223–1228.

24.

Gurney

et al. Free-breathing multiphase whole-heart coronary MR angiography using image-based navigators and three-dimensional cones imaging. Magn Reson Med 2013; 69:1083–1093.

25.

Kato

Kitagawa

Ishida

et al. Assessment of coronary artery disease using magnetic resonance coronary angiography: a national multicenter trial. J Am Coll Cardiol 2010; 56:983–991.

26.

Park

Deshpande

et al. Reduction of flow- and eddy-currents-induced image artifacts in coronary magnetic resonance angiography using a linear centric-encoding SSFP sequence. Magn Reson Imaging 2007; 25:1138–1147.

27.

Roes

Korosoglou

Schär

et al. Correction for heart rate variability during 3D whole heart MR coronary angiography. J Magn Reson Imaging 2008; 27:1046–1053.

28.

Shechter

Resar

McVeigh

. Displacement and velocity of the coronary arteries: cardiac and respiratory motion. IEEE Trans Med Imaging 2006; 25:369–375.

29.

Liu

X-L

Robert

et al. Ultrasound-guided identification of cardiac imaging windows. Med Phys 2012; 39:3009–3018.

30.

Uribe

Tangchaoren

Parish

et al. Volumetric cardiac quantification by using 3D dual-phase whole-heart MR imaging. Radiology 2008; 248:606–614.

31.

Delgado

Abad

Rascovsky

et al. Assessment of cardiac volumes using an isotropic whole-heart dual cardiac phase sequence in pediatric patients. J Magn Reson Imaging 2014; 39:708–716.

32.

Carr

Simonetti

Bundy

et al. Cine MR angiography of the heart with segmented true fast imaging with steady-state precession. Radiology 2001; 219:828–834.

33.

Thiele

Nagel

Paetsch

et al. Functional cardiac MR imaging with steady-state free precession (SSFP) significantly improves endocardial border delineation without contrast agents. J Magn Reson Imaging 2001; 14:362–367.

34.

Fenchel

Greil

Martirosian

et al. Three-dimensional morphological magnetic resonance imaging in infants and children with congenital heart disease. Pediatr Radiol 2006; 36:1265–1272.

35.

Groves

Chiesa

Durighel

et al. Functional cardiac MRI in preterm and term newborns. Arch Dis Child Fetal Neonatal Ed 2011; 96:F86–91.

36.

Maceira

Prasad

Khan

et al. Normalized left ventricular systolic and diastolic function by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2006; 8:417–426.

37.

Seeger

Fenchel

Greil

et al. Three-dimensional cine MRI in free-breathing infants and children with congenital heart disease. Pediatr Radiol 2009; 39:1333–1342.

38.

Uribe

Muthurangu

Boubertakh

et al. Whole-heart cine MRI using real-time respiratory self-gating. Magn Reson Med 2007; 57:606–613.

39.

Hussain

Lossnitzer

Bellsham-Revell

et al. Three-dimensional dual-phase whole-heart MR imaging: clinical implications for congenital heart disease. Radiology 2012; 263:547–554.

40.

Liu

Spincemaille

Codella

NCF

et al. Respiratory and cardiac self-gated free-breathing cardiac CINE imaging with multiecho 3D hybrid radial SSFP acquisition. Magn Reson Med 2010; 63:1230–1237.

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Multi-phase coronary magnetic resonance angiography improves delineation of coronary arteries

Abstract

Abstract

Background

Purpose

Material and Methods

Results

Conclusion

Keywords

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References

Supplementary Material