title: Spiral magnetic resonance coronary angiography with rapid real-time localization.
abstract: A spiral high-resolution coronary artery imaging sequence (SH) interfaced with real-time localization system (RT) has been developed. A clinical study of 40 patients suspected of coronary artery disease (CAD) was conducted. Segmented k-space acquisition techniques have dominated magnetic resonance coronary angiography (MRCA) over the last decade. Although a recent multicenter trial using this technique demonstrated encouraging results, the technique was hampered by low specificity. Spiral k-space acquisition had demonstrated several advantages for MRCA. Therefore, a first clinical trial implementing spiral high-resolution coronary imaging sequence with real-time localization (SH-RT) was performed.A clinical study of 40 patients suspected of CAD undergoing X-ray angiography was conducted to analyze the clinical reliability of this novel imaging system. The SH-RT had been designed to exploit the unique capability of two imaging sequences. The RT allowed a rapid localization of the coronary arteries. Then SH achieved multislice acquisition during a short breath-hold with submillimeter resolution. The MRCA data were analyzed for scan time, anatomic coverage, image quality, and accuracy in detecting CAD. In 40 subjects, SH achieved 0.7 to 0.9 mm resolution with 14-heartbeat breath-holds. Excellent or good image quality was achieved in 78% (263/337) of the coronary segments. Blinded consensus reading among three observers generated sensitivity of 76% and specificity of 91% in the detection of CAD compared with X-ray angiography. The MRCA imaging sequence implementing a novel spiral k-space acquisition technique enabled rapid and reliable imaging of the CAD in submillimeter resolution with short breath-holds.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Stanford, California 94305-5233, USA. pyang@cvmed.stanford.edu
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Yang
authors.forename: Craig H
authors.initials: CH
authors.lastname: Meyer
authors.forename: Masahiro
authors.initials: M
authors.lastname: Terashima
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Kaji
authors.forename: Michael V
authors.initials: MV
authors.lastname: McConnell
authors.forename: A l
authors.initials: Al
authors.lastname: Macovski
authors.forename: John M
authors.initials: JM
authors.lastname: Pauly
authors.forename: Dwight G
authors.initials: DG
authors.lastname: Nishimura
authors.forename: Bob S
authors.initials: BS
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis*; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000473:pathology; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors