Korean J Radiol.  2006 Dec;7(4):235-242. 10.3348/kjr.2006.7.4.235.

Feasibility and Diagnostic Accuracy of Whole Heart Coronary MR Angiography Using Free-Breathing 3D Balanced Turbo-Field-Echo with SENSE and the Half-Fourier Acquisition Technique

• Kim YJ
• Seo JS
• Choi BW
• Choe KO
• Jang Y
• Ko YG

• KMID: 1092546
• DOI: http://doi.org/10.3348/kjr.2006.7.4.235

Abstract

OBJECTIVE
We wanted to assess the feasibility and diagnostic accuracy of whole heart coronary magnetic resonance angiography (MRA) with using 3D balanced turbo-field-echo (b-TFE) with SENSE and the half-Fourier acquisition technique for identifying stenoses of the coronary artery. MATERIALS AND METHODS: Twenty-one patients who underwent both whole heart coronary MRA examinations and conventional catheter coronary angiography examinations were enrolled in the study. The whole heart coronary MRA images were acquired using a navigator gated 3D b-TFE sequence with SENSE and the half-Fourier acquisition technique to reduce the acquisition time. The imaging slab covered the whole heart (80 contiguous slices with a reconstructed slice thickness of 1.5 mm) along the transverse axis. The quality of the images was evaluated by using a 5-point scale (0 - uninterpretable, 1 - poor, 2 - fair, 3 - good, 4 - excellent). Ten coronary segments of the heart were evaluated in each case; the left main coronary artery (LM), and the proximal, middle and distal segments of the left anterior descending (LAD), the left circumflex (LCX) and the right coronary artery (RCA). The diagnostic accuracy of whole heart coronary MRA for detecting significant coronary artery stenosis was determined on the segment-by-segment basis, and it was compared with the results obtained by conventional catheter angiography, which is the gold standard. RESULTS: The mean image quality was 3.7 in the LM, 3.2 in the LAD, 2.5 in the LCX, and 3.3 in the RCA, respectively (the overall image quality was 3.0+/-0.1). 168 (84%) of the 201 segments had an acceptable image quality (> or = grade 2). The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the whole heart coronary MRA images for detecting significant stenosis were 81.3%, 92.1%, 91.1%, 97.9%, and 52.0%, respectively. The mean coronary MRA acquisition time was 9 min 22 sec (+/-125 sec). CONCLUSION: Whole heart coronary MRA is a feasible technique, and it has good potential to evaluate the major portions of the coronary arteries with an acceptable image quality within a reasonable scan time.

Keyword

Coronary angiography; Magnetic resonance (MR), angiography

MeSH Terms

Reproducibility of Results
Middle Aged
Male
Magnetic Resonance Angiography/*methods
*Imaging, Three-Dimensional
Humans
Fourier Analysis
Female
Feasibility Studies
Coronary Stenosis/*diagnosis
Coronary Angiography
Analysis of Variance
Aged
Adult

Figure

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  Fig. 1 A 48-year-old woman who was diagnosed with hypertrophic cardiomyopathy. Source images (A, B), the multiplanar reformatted image (C) and the volume rendering image (D) of whole heart coronary MRA show normal major epicardial coronary arteries.

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  Fig. 2 A 53-year-old man who presented with chest pain. A, B. Source images of whole heart coronary MRA demonstrate a signal loss (arrow in B) at the middle segment of the right coronary artery, which is indicative of significant stenosis. C. planar reformatted image along the right coronary artery course shows an abrupt signal loss at the middle segment of the right coronary artery (arrow) and multifocal signal reduction (arrowheads) at the proximal portion. D. Conventional catheter coronary angiography shows a total occlusion of the middle segment of the right coronary artery and multifocal mild stenosis of the proximal and middle segments.

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