Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing.
Recently, there has been increased interest in imaging the coronary vein anatomy to guide interventional cardiovascular procedures such as cardiac resynchronization therapy (CRT), a device therapy for congestive heart failure (CHF). With CRT the lateral wall of the left ventricle is electrically paced using a transvenous coronary sinus lead or surgically placed epicardial lead. Proper transvenous lead placement is facilitated by the knowledge of the coronary vein anatomy. Cardiovascular MR (CMR) has the potential to image the coronary veins. In this study we propose and test CMR techniques and protocols for imaging the coronary venous anatomy. Three aspects of design of imaging sequence were studied: magnetization preparation schemes (T(2) preparation and magnetization transfer), imaging sequences (gradient-echo (GRE) and steady-state free precession (SSFP)), and imaging time during the cardiac cycle. Numerical and in vivo studies both in healthy and CHF subjects were performed to optimize and demonstrate the utility of CMR for coronary vein imaging. Magnetization transfer was superior to T(2) preparation for contrast enhancement. Both GRE and SSFP were viable imaging sequences, although GRE provided more robust results with better contrast. Imaging during the end-systolic quiescent period was preferable as it coincided with the maximum size of the coronary veins.
Nezafat
Reza
R
Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. rnezafat@bidmc.harvard.edu
Han
Yuchi
Y
Peters
Dana C
DC
Herzka
Daniel A
DA
Wylie
John V
JV
Goddu
Beth
B
Kissinger
Kraig K
KK
Yeon
Susan B
SB
Zimetbaum
Peter J
PJ
Manning
Warren J
WJ
D000328:Adult; D000465:Algorithms; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006333:Heart Failure / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014680:Veins / Q000473:pathology*