title: Breath-hold imaging of the coronary arteries using Quiescent-Interval Slice-Selective (QISS) magnetic resonance angiography: pilot study at 1.5 Tesla and 3 Tesla.
abstract: BACKGROUND
  Coronary magnetic resonance angiography (MRA) is usually obtained with a free-breathing navigator-gated 3D acquisition. Our aim was to develop an alternative breath-hold approach that would allow the coronary arteries to be evaluated in a much shorter time and without risk of degradation by respiratory motion artifacts. For this purpose, we implemented a breath-hold, non-contrast-enhanced, quiescent-interval slice-selective (QISS) 2D technique. Sequence performance was compared at 1.5 and 3 Tesla using both radial and Cartesian k-space trajectories.
  
  
  METHODS
  The left coronary circulation was imaged in six healthy subjects and two patients with coronary artery disease. Breath-hold QISS was compared with T2-prepared 2D balanced steady-state free-precession (bSSFP) and free-breathing, navigator-gated 3D bSSFP.
  
  
  RESULTS
  Approximately 10 2.1-mm thick slices were acquired in a single ~20-s breath-hold using two-shot QISS. QISS contrast-to-noise ratio (CNR) was 1.5-fold higher at 3 Tesla than at 1.5 Tesla. Cartesian QISS provided the best coronary-to-myocardium CNR, whereas radial QISS provided the sharpest coronary images. QISS image quality exceeded that of free-breathing 3D coronary MRA with few artifacts at either field strength. Compared with T2-prepared 2D bSSFP, multi-slice capability was not restricted by the specific absorption rate at 3 Tesla and pericardial fluid signal was better suppressed. In addition to depicting the coronary arteries, QISS could image intra-cardiac structures, pericardium, and the aortic root in arbitrary slice orientations.
  
  
  CONCLUSIONS
  Breath-hold QISS is a simple, versatile, and time-efficient method for coronary MRA that provides excellent image quality at both 1.5 and 3 Tesla. Image quality exceeded that of free-breathing, navigator-gated 3D MRA in a much shorter scan time. QISS also allowed rapid multi-slice bright-blood, diastolic phase imaging of the heart, which may have complementary value to multi-phase cine imaging. We conclude that, with further clinical validation, QISS might provide an efficient alternative to commonly used free-breathing coronary MRA techniques.
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. Redelman999@gmail.com.|Feinberg School of Medicine, Northwestern University, Chicago, USA. Redelman999@gmail.com.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edelman
authors.affiliation: Siemens Medical Solutions USA, Inc., Chicago, USA. shivraman.giri@siemens.com.
authors.forename: S
authors.initials: S
authors.lastname: Giri
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. apursnani@northshore.org.|The University of Chicago Pritzker School of Medicine, Chicago, USA. apursnani@northshore.org.
authors.forename: A
authors.initials: A
authors.lastname: Pursnani
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. marcos.botelho@northwestern.edu.
authors.forename: M P F
authors.initials: MP
authors.lastname: Botelho
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. wli@northshore.org.|The University of Chicago Pritzker School of Medicine, Chicago, USA. wli@northshore.org.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL, 60201, USA. ikoktzoglou@gmail.com.|The University of Chicago Pritzker School of Medicine, Chicago, USA. ikoktzoglou@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Koktzoglou
mesh_terms: D000328:Adult; D062485:Breath Holding; D016022:Case-Control Studies; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000473:pathology* / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013997:Time Factors