Abstract 2806: Whole Heart Coronary Magnetic Resonance Angiography Using 32-Channel Cardiac Coils and High Parallel Imaging Factor

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Motonori Nagata ◽  
Hajime Sakuma ◽  
Nanaka Ishida ◽  
Hiroshi Nakajima ◽  
Masaki Ishida ◽  
...  

PURPOSE Coronary MRA provides noninvasive detection of coronary artery disease (CAD) without administration of contrast medium or exposing the patient to radiation. However, use of coronary MRA in excluding patients with CAD has been limited due to lengthy imaging time. The purpose of this study was to reduce acquisition time of coronary MRA by using 32 channel cardiac coils and high parallel imaging factor, and to evaluate diagnostic performance of this method in detecting significant CAD. METHOD AND MATERIALS Sixty-two patients with suspected CAD were studied. Free-breathing coronary MRA encompassing the entire heart was acquired by using 32-channel coils and SENSE factor of 4. After monitoring motion of the coronary artery on cine MRI, MR angiograms were acquired during diastole in 46 patients (acquisition window 82±57ms) and during systole in 16 patients (50±19ms). Coronary MRA images were interpreted by 2 observers by employing a sliding SLAB MIP method. All patients underwent X-ray coronary angiography within 4 weeks from MRA, and significant CAD was defined as a luminal diameter reduction of 50% or more by QCA. All lesions with a reference diameter of 2mm or more on X-ray angiography were included when determining the accuracy of coronary MRA. RESULTS Acquisition of MRA was completed in all 62 patients, with the averaged imaging time of 6.1±2.6min. High SENSE factor achieved by 32-channel coils resulted in substantial reduction of imaging time by factor of >2, with the image quality score (4.6±0.2) at least equivalent to that by conventional 5-channel coils and SENSE factor of 2 (4.5±0.2). Significant CAD was observed on X-ray coronary angiography in 39 patients. MRA detected 33(85%) of 39 patients having CAD, with high specificity of 96%(22/23). All 16 patients with double- or triple-vessel diseases were detected by MRA. On a vessel based analysis, Whole-heart coronary MRA demonstrated sensitivity of 83%(49/59), specificity of 94%(119/127) and NPV of 92%(119/129). CONCLUSION Whole-heart coronary MRA with 1.5T MR imager and 32-chennel coils permits noninvasive detection of CAD with substantially reduced imaging time and high study success rate. High NPV (>90%) indicated the value of this approach in ruling out significant CAD.

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Shingo Kato ◽  
Hajime Sakuma ◽  
Nanaka Ishida ◽  
Masaki Ishida ◽  
Motonori Nagata ◽  
...  

Background: CT coronary angiography is widely used to assess the presence of significant coronary artery disease (CAD). However, CT approach is associated with low but nonnegligible cancer risk. The purpose of this prospective multicenter study was to evaluate the diagnostic performance of coronary magnetic resonance angiography (MRA) in the ability to identify patients with significant CAD compared with coronary angiography. Materials and Methods: The subjects were recruited from 7 institutions. Free breathing coronary MR angiograms covering the entire coronary artery tree were obtained in 138 patients who were suspicious of CAD. Non-contrast enhanced images were acquired with a commercial 1.5T MR imager and five-element cardiac coils after sublingual administration of isosorbide dinitrate. Conventional X-ray coronary angiography was performed within 4 weeks after coronary MRA. MR and X-ray angiograms were sent to a core laboratory for blinded interpretation. Coronary MR angiograms were evaluated by two experienced investigators by using sliding partial MIP reconstruction. Quantitative X-ray coronary angiography analysis was performed with significant CAD defined as luminal narrowing of at least 50% of the diameter. Results: The mean imaging time of coronary MRA was 9.5 ± 4.9 minutes. The prevalence of significant disease on X-ray angiography was 45% (62/138). On a vessel-based analysis, the area under receiver operating characteristic (ROC) curve for the MRA compared with X-ray angiography was 0.90 (95% CI; 0.86 to 0.93). On a patient based analysis, the ROC area was 0.88 (95% CI; 0.81– 0.93). The sensitivity, specificity, positive and negative predictive values of coronary MRA by vessel analysis were 78% (95% CI; 68 – 86%), 86% (82–90%), 60% (51– 69%), 94% (90–96%). These values by patient analysis were 87% (95% CI; 76–94%), 71% (59 – 81%), 71% (59 – 81%), 87% (76–94%). Conclusions: In the current multicenter study using commercial 1.5T MR imagers and sliding partial MIP reconstruction, the diagnostic accuracy of coronary MRA compared to quantitative coronary angiography is good, reflected by an ROC area of 0.88 on patient-based analysis. High negative predictive value indicates that coronary MRA can be used for screening CAD.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Yasutaka Ichikawa ◽  
Hajime Sakuma ◽  
Yasuyuki Kobayashi ◽  
Masaki Ishida ◽  
Kazuhiro Katahira ◽  
...  

Background: Previous single center studies demonstrated that coronary magnetic resonance angiography (MRA) with whole heart coverage allows for noninvasive detection of coronary artery disease. In this prospective, multicenter study, we investigated the accuracy of whole heart coronary MRA in patients with suspected coronary disease. Methods: The subjects were recruited from five institutions. Free-breathing coronary MRA covering the entire heart were obtained in fifty eight patients by using a 3-dimensional, segmented steady-state free precession sequence without contrast injection. Coronary MRA was interpreted by 3 independent observers. Conventional X-ray coronary angiography was analyzed by a separate blinded reviewer. The diagnostic accuracy of coronary MRA was determined in all segments with reference diameter of 2 mm or more on X-ray coronary angiography regardless of the image quality of MRA. Results: Acquisition of coronary MRA was completed in all patients with an averaged imaging time of 9.8 ± 4.8 min. On patient based analysis, coronary MRA showed the sensitivity of 79.4% (range 64.7–88.2%), the specificity of 70.1% (65.9–80.5%), and the negative predictive value of 89.6% (84.6–93.1%). The sensitivity, specificity and negative predictive value in the segmental analysis were 60.6% (53.8–65.4%), 95.5% (94.2–97.6%) and 97.7% (97.4–98.1%). Conclusions: Coronary MRA with whole heart coverage can provide detection of luminal narrowing of the coronary artery with moderate sensitivity, high specificity and high negative predictive value. The high negative predictive value observed in this multicenter study indicates that noninvasive MRA approach is useful in ruling out significant coronary artery disease.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1998-2002
Author(s):  
Sheela D. Kadam ◽  
Abhijeet Shelke ◽  
Priya P Roy ◽  
Megha A Doshi ◽  
Shruti P Mohite

Coronary artery disease (CAD) is going to become a significant cause of death in the world. The CAD is increasing day by day because of the changing lifestyle of people. The responsible factors for CAD are diabetes, hypertension, addiction and heredity also. So, the present work is undertaken to study the dominant pattern of coronary artery in the Maharashtra population. The present study was a hospital-based, prospective and observational study of 360 patients who have coronary artery disease undergoing coronary angiography.  This study carried out from May 2018-November 2019 of both genders of 25 years of age and above [Male-215(59.72%) and female was 145(40.27 %)]. Out of that, the youngest patient below 40 years male was 30(73.17%), and the female was 11(26. 82%). While above 40 years males were 185(57.99%) and females was 134(42%). The patients with a history of by-pass surgery and angioplasty were excluded. Invasive angiography was performed by either femoral or radial artery using radio-opaque dye (OMNIPCK-50ml) that is visible by an x-ray machine (GE. INNOVA). The socio-demographic Proforma of patients, the pattern of coronary arterial dominance were recorded. Right coronary artery was dominant in 273(75.83%) patients observed in this study. While LCx was dominant in 49(13.6%) and co-dominant in 38 (10.55%) patients. Knowledge of study can be helpful to cardiologists for anatomical assessment of coronary arteries for diagnostic purposes and invasive studies.


Herz ◽  
2022 ◽  
Author(s):  
Uzair Ansari ◽  
Sonja Janssen ◽  
Stefan Baumann ◽  
Martin Borggrefe ◽  
Stephan Waldeck ◽  
...  

Abstract Background We investigated the feasibility of evaluating coronary arteries with a contrast-enhanced (CE) self-navigated sparse isotropic 3D whole heart T1-weighted magnetic resonance imaging (MRI) study sequence. Methods A total of 22 consecutive patients underwent coronary angiography and/or cardiac computed tomography (CT) including cardiac MRI. The image quality was evaluated on a 3-point Likert scale. Inter-reader variability for image quality was analyzed with Cohen’s kappa for the main coronary segments (left circumflex [LCX], left anterior descending [LAD], right coronary artery [RCA]) and the left main trunk (LMT). Results Inter-reader agreement for image quality of the coronary tree ranged from substantial to perfect, with a Cohen’s kappa of 0.722 (RCAmid) to 1 (LCXprox). The LMT had the best image quality. Image quality of the proximal vessel segments differed significantly from the mid- and distal segments (RCAprox vs. RCAdist, p < 0.05). The LCX segments showed no significant difference in image quality along the vessel length (LCXprox vs. LCXdist, p = n.s.). The mean acquisition time for the study sequence was 553 s (±46 s). Conclusion Coronary imaging with a sparse 3D whole-heart sequence is feasible in a reasonable amount of time producing good-quality imaging. Image quality was poorer in distal coronary segments and along the entire course of the LCX.


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