Magnetic resonance imaging of the coronary arteries: clinical results from three dimensional evaluation of a respiratory gated technique.
BACKGROUND
Magnetic resonance coronary angiography is challenging because of the motion of the vessels during cardiac contraction and respiration. Additional challenges are the small calibre of the arteries and their complex three dimensional course. Respiratory gating, turboflash acquisition, and volume rendering techniques may meet the necessary requirements for appropriate visualisation.


OBJECTIVE
To determine the diagnostic accuracy of respiratory gated magnetic resonance imaging (MRI) for the detection of significant coronary artery stenoses evaluated with three dimensional postprocessing software.


METHODS
32 patients referred for elective coronary angiography were studied with a retrospective respiratory gated three dimensional gradient echo MRI technique. Resolution was 1.9 x 1.25 x 2 mm. After manual segmentation three dimensional evaluation was performed with a volume rendering technique.


RESULTS
Overall 74% (range 50% to 90%) of the proximal and mid coronary artery segments were visualised with an image quality suitable for further analysis. Sensitivity and specificity for the detection of significant stenoses were 50% and 91%, respectively.


CONCLUSIONS
Volume rendering of respiratory gated MRI techniques allows adequate visualisation of the coronary arteries in patients with a regular breathing pattern. Significant lesions in the major coronary artery branches can be identified with a moderate sensitivity and a high specificity.
van Geuns
R J
RJ
Department of Cardiology, Thoraxcenter, University Hospital Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands. vanguens@card.azr.nl
de Bruin
H G
HG
Rensing
B J
BJ
Wielopolski
P A
PA
Hulshoff
M D
MD
van Ooijen
P M
PM
Oudkerk
M
M
de Feyter
P J
PJ
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity