title: Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing.
abstract: 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.
authors.affiliation: Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. rnezafat@bidmc.harvard.edu
authors.forename: Reza
authors.initials: R
authors.lastname: Nezafat
authors.forename: Yuchi
authors.initials: Y
authors.lastname: Han
authors.forename: Dana C
authors.initials: DC
authors.lastname: Peters
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Herzka
authors.forename: John V
authors.initials: JV
authors.lastname: Wylie
authors.forename: Beth
authors.initials: B
authors.lastname: Goddu
authors.forename: Kraig K
authors.initials: KK
authors.lastname: Kissinger
authors.forename: Susan B
authors.initials: SB
authors.lastname: Yeon
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Zimetbaum
authors.forename: Warren J
authors.initials: WJ
authors.lastname: Manning
mesh_terms: 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*