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Lu H, Zhao S, Tian D, Chen Y, Ma J, Ge M, Zeng M, Jin H. A clinical strategy to improve the diagnostic performance of 3T non-contrast coronary MRA and noninvasively evaluate coronary distensibility: combination of diastole and systole imaging. J Cardiovasc Magn Reson 2023; 25:67. [PMID: 37993897 PMCID: PMC10666457 DOI: 10.1186/s12968-023-00982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND The clinical application of coronary MR angiography (MRA) combining diastole and systole imaging has never been described comprehensively in coronary artery disease (CAD) patients. We aimed to design an optimal non-contrast coronary MRA scan protocol combining diastolic and systolic imaging and to (1) evaluate its diagnostic performance for detecting significant coronary stenosis; (2) evaluate the feasibility of this protocol to noninvasively measure the coronary distensibility index (CDI). METHODS From June 2021 to May 2022, 33 healthy volunteers and 91 suspected CAD patients scheduled for X-ray coronary angiography (CAG) were prospectively enrolled. 3T non-contrast water-fat coronary MRA was carried out twice at diastole and systole. Significant coronary stenosis was defined as a luminal diameter reduction of ≥ 50% using CAG as the reference and was evaluated as follows: (1) by coronary MRA in diastole alone; (2) by coronary MRA in systole alone; (3) by combined coronary MRA in diastole and systole. According to CAG, the patients were divided into significant CAD patients and non-significant CAD patients. The difference in CDI among participants was evaluated. RESULTS Combined coronary MRA was completed in 31 volunteers and 76 patients. The per-patient sensitivity, specificity, and accuracy of combined coronary MRA were 97.5%, 83.3%, and 90.8%, respectively. Compared with single diastolic mode, combined coronary MRA showed equally high sensitivity but improved specificity on a per-patient basis (83.3% vs. 63.9%, adjusted P = 0.013). The CDI tested by coronary MRA decreased incrementally from healthy volunteers to non-significant and significant CAD patients. CONCLUSION Compared with single-phase mode, 3 T non-contrast combined coronary MRA significantly improved specificity and may have potential to be a simple noninvasive method to measure CDI.
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Affiliation(s)
- Hongfei Lu
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Shihai Zhao
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China
| | - Di Tian
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Yinyin Chen
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China
| | - Jianying Ma
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Meiying Ge
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China.
| | - Hang Jin
- Department of Radiology, Zhongshan Hospital, Fudan University and Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Shanghai, 200032, China.
- Department of Radiology, Zhongshan Hospital (Minhang Meilong Branch), Fudan University and Shanghai Geriatric Medical Center, Shanghai, 200237, China.
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2
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Heerfordt J, Whitehead KK, Bastiaansen JAM, Di Sopra L, Roy CW, Yerly J, Milani B, Fogel MA, Stuber M, Piccini D. Similarity-driven multi-dimensional binning algorithm (SIMBA) for free-running motion-suppressed whole-heart MRA. Magn Reson Med 2021; 86:213-229. [PMID: 33624348 DOI: 10.1002/mrm.28713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/19/2020] [Accepted: 01/11/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Whole-heart MRA techniques typically target predetermined motion states, address cardiac and respiratory dynamics independently, and require either complex planning or computationally demanding reconstructions. In contrast, we developed a fast data-driven reconstruction algorithm with minimal physiological assumptions and compatibility with ungated free-running sequences. THEORY AND METHODS We propose a similarity-driven multi-dimensional binning algorithm (SIMBA) that clusters continuously acquired k-space data to find a motion-consistent subset for whole-heart MRA reconstruction. Free-running 3D radial data sets from 12 non-contrast-enhanced scans of healthy volunteers and six ferumoxytol-enhanced scans of pediatric cardiac patients were reconstructed with non-motion-suppressed regridding of all the acquired data ("All Data"), with SIMBA, and with a previously published free-running framework (FRF) that uses cardiac and respiratory self-gating and compressed sensing. Images were compared for blood-myocardium sharpness and contrast ratio, visibility of coronary artery ostia, and right coronary artery sharpness. RESULTS Both the 20-second SIMBA reconstruction and FRF provided significantly higher blood-myocardium sharpness than All Data in both patients and volunteers (P < .05). The SIMBA reconstruction provided significantly sharper blood-myocardium interfaces than FRF in volunteers (P < .001) and higher blood-myocardium contrast ratio than All Data and FRF, both in volunteers and patients (P < .05). Significantly more ostia could be visualized with both SIMBA (31 of 36) and FRF (34 of 36) than with All Data (4 of 36) (P < .001). Inferior right coronary artery sharpness using SIMBA versus FRF was observed (volunteers: SIMBA 36.1 ± 8.1%, FRF 40.4 ± 8.9%; patients: SIMBA 35.9 ± 7.7%, FRF 40.3 ± 6.1%, P = not significant). CONCLUSION The SIMBA technique enabled a fast, data-driven reconstruction of free-running whole-heart MRA with image quality superior to All Data and similar to the more time-consuming FRF reconstruction.
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Affiliation(s)
- John Heerfordt
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Kevin K Whitehead
- Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jessica A M Bastiaansen
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Lorenzo Di Sopra
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Christopher W Roy
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jérôme Yerly
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne, Switzerland
| | - Bastien Milani
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mark A Fogel
- Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Matthias Stuber
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Center for Biomedical Imaging, Lausanne, Switzerland
| | - Davide Piccini
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
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3
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Cavallo AU, Koktzoglou I, Edelman RR, Gilkeson R, Mihai G, Shin T, Rajagopalan S. Noncontrast Magnetic Resonance Angiography for the Diagnosis of Peripheral Vascular Disease. Circ Cardiovasc Imaging 2019; 12:e008844. [DOI: 10.1161/circimaging.118.008844] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Armando Ugo Cavallo
- Departments of Medicine and Radiology, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland OH (A.U.C., R.G., T.S., S.R.)
- Division of Diagnostic and Interventional Radiology, University Hospital Policlinico “Tor Vergata”, Roma, Italy (A.U.C.)
| | - Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL (I.K., R.R.E.)
- University of Chicago Pritzker School of Medicine, IL (I.K.)
| | - Robert R. Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL (I.K., R.R.E.)
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL (R.R.E.)
| | - Robert Gilkeson
- Departments of Medicine and Radiology, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland OH (A.U.C., R.G., T.S., S.R.)
| | - Georgeta Mihai
- Beth Israel Deaconess Hospital, Harvard Medical School, Boston, MA (G.M.)
| | - Taehoon Shin
- Departments of Medicine and Radiology, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland OH (A.U.C., R.G., T.S., S.R.)
- Division of Mechanical and Biomedical Engineering, Ewha Womans University, Seoul, South Korea (T.S.)
| | - Sanjay Rajagopalan
- Departments of Medicine and Radiology, University Hospitals, Harrington Heart & Vascular Institute, Case Western Reserve University, Cleveland OH (A.U.C., R.G., T.S., S.R.)
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4
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Feng L, Coppo S, Piccini D, Yerly J, Lim RP, Masci PG, Stuber M, Sodickson DK, Otazo R. 5D whole-heart sparse MRI. Magn Reson Med 2017; 79:826-838. [PMID: 28497486 DOI: 10.1002/mrm.26745] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 04/09/2017] [Accepted: 04/11/2017] [Indexed: 01/18/2023]
Abstract
PURPOSE A 5D whole-heart sparse imaging framework is proposed for simultaneous assessment of myocardial function and high-resolution cardiac and respiratory motion-resolved whole-heart anatomy in a single continuous noncontrast MR scan. METHODS A non-electrocardiograph (ECG)-triggered 3D golden-angle radial balanced steady-state free precession sequence was used for data acquisition. The acquired 3D k-space data were sorted into a 5D dataset containing separated cardiac and respiratory dimensions using a self-extracted respiratory motion signal and a recorded ECG signal. Images were then reconstructed using XD-GRASP, a multidimensional compressed sensing technique exploiting correlations/sparsity along cardiac and respiratory dimensions. 5D whole-heart imaging was compared with respiratory motion-corrected 3D and 4D whole-heart imaging in nine volunteers for evaluation of the myocardium, great vessels, and coronary arteries. It was also compared with breath-held, ECG-gated 2D cardiac cine imaging for validation of cardiac function quantification. RESULTS 5D whole-heart images received systematic higher quality scores in the myocardium, great vessels and coronary arteries. Quantitative coronary sharpness and length were always better for the 5D images. Good agreement was obtained for quantification of cardiac function compared with 2D cine imaging. CONCLUSION 5D whole-heart sparse imaging represents a robust and promising framework for simplified comprehensive cardiac MRI without the need for breath-hold and motion correction. Magn Reson Med 79:826-838, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Li Feng
- Center for Advanced Imaging Innovation and Research (CAI2R), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Simone Coppo
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Davide Piccini
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland
| | - Jerome Yerly
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Ruth P Lim
- Department of Radiology, Austin Health and The University of Melbourne, Melbourne, Victoria, Australia
| | - Pier Giorgio Masci
- Division of Cardiology and Cardiac MR Center, University Hospital (CHUV), Lausanne, Switzerland
| | - Matthias Stuber
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Daniel K Sodickson
- Center for Advanced Imaging Innovation and Research (CAI2R), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ricardo Otazo
- Center for Advanced Imaging Innovation and Research (CAI2R), and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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5
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Shin T, Qin Q, Park JY, Crawford RS, Rajagopalan S. Identification and reduction of image artifacts in non-contrast-enhanced velocity-selective peripheral angiography at 3T. Magn Reson Med 2016; 76:466-77. [PMID: 26308243 PMCID: PMC4769124 DOI: 10.1002/mrm.25870] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 07/14/2015] [Accepted: 07/14/2015] [Indexed: 01/13/2023]
Abstract
PURPOSE To identify and reduce image artifacts in non-contrast-enhanced velocity-selective (VS) magnetization-prepared peripheral MR angiography (MRA) at 3T. METHODS To avoid signal loss in the arteries, double and quadruple refocused VS excitation pulse sequences were designed that were robust to a wide range of B0 and B1 offset. To suppress stripe artifact and background signal variation, we successively applied two VS preparations with excitation profiles shifted by half the period of the stripes. VS-MRA using single, double, and quadruple refocused VS preparations was tested in healthy subjects and a patient. RESULTS In the regions of large B0 and B1 offsets, arterial signal loss was yielded by single refocused VS preparation, but was avoided with double or quadruple refocused preparations. Compared with single VS preparation, the two consecutive preparations with shifted excitation profiles substantially reduced the stripe artifact and background signal variation, as demonstrated by increased mean and decreased standard deviation of relative contrast-to-noise ratio. The proposed VS-MRA identified multilevel disease in the femoral arteries of the patient, as validated by digital subtraction angiography. CONCLUSION Two multiple refocused VS magnetization preparations with shifted excitation profiles yield artifact-free peripheral angiograms at 3T. Magn Reson Med 76:466-477, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Taehoon Shin
- Department of Diagnostic Radiology and Nuclear Medicine, University
of Maryland, Baltimore, Maryland
| | - Qin Qin
- Department of Radiology, Johns Hopkins University, Baltimore,
Maryland
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy
Krieger Institute, Baltimore, Maryland
| | - Jang-Yeon Park
- Center for Neuroscience Imaging Research, Institute for Basic
Science, Suwon, South Korea
- Department of Biomedical Engineering, Sungkyunkwan University,
Suwon, South Korea
| | - Robert S. Crawford
- Division of Vascular and Endovascular Surgery, University of
Maryland, Baltimore, Maryland
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, University of Maryland,
Baltimore, Maryland
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6
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Pang J, Chen Y, Fan Z, Nguyen C, Yang Q, Xie Y, Li D. High efficiency coronary MR angiography with nonrigid cardiac motion correction. Magn Reson Med 2016; 76:1345-1353. [PMID: 27455164 DOI: 10.1002/mrm.26332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/09/2016] [Accepted: 06/15/2016] [Indexed: 11/05/2022]
Abstract
PURPOSE To improve the coronary visualization quality of four-dimensional (4D) coronary MR angiography (MRA) through cardiac motion correction and iterative reconstruction. METHODS A contrast-enhanced, spoiled gradient echo sequence with 3D radial trajectory and self-gating was used for 4D coronary MRA data acquisition at 3 Tesla. A whole-heart 16-phase cine series was reconstructed with respiratory motion correction. Nonrigid registration was performed between the identified quiescent phases and a reference. The motion information of all included phases was then used along with the corresponding k-space data to iteratively reconstruct the final image. Healthy volunteer studies (N = 13) were conducted to compare the proposed method with the conventional strategy, which accepts data from a single, contiguous window out of the original 16-phase data. Apparent signal-to-noise ratio (aSNR) and coronary sharpness were used as the image quality metrics. RESULTS The proposed method significantly improved aSNR (11.89 ± 3.76 to 13.97 ± 5.21; P = 0.005) and scan efficiency (18.8% ± 6.0% to 40.9% ± 9.7%; P < 0.001), compared with the conventional strategy. Sharpness of left main (P = 0.002), proximal (P = 0.04), and middle (P = 0.02) right coronary artery, and proximal left anterior descending (P = 0.04) was also significantly improved. CONCLUSION The proposed cardiac motion-corrected reconstruction significantly improved the achievable quality of coronary visualization from 4D coronary MRA. Magn Reson Med 76:1345-1353, 2016. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Jianing Pang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yuhua Chen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Computer and Information Science, University of Pennsylvania, Philadelphia, Pennyslvania, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Christopher Nguyen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Qi Yang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. .,Bioengineering, University of California, Los Angeles, California, USA.
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7
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Menon RG, Miller GW, Jeudy J, Rajagopalan S, Shin T. Free breathing three-dimensional late gadolinium enhancement cardiovascular magnetic resonance using outer volume suppressed projection navigators. Magn Reson Med 2016; 77:1533-1543. [PMID: 27122450 DOI: 10.1002/mrm.26234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/09/2016] [Accepted: 03/10/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE To develop a three-dimensional, free-breathing, late gadolinium enhancement (3D FB-LGE) cardiovascular magnetic resonance (CMR) technique, and to compare it with clinically used two-dimensional breath-hold LGE (2D BH-LGE). METHODS The proposed 3D FB-LGE method consisted of inversion preparation, inversion delay, fat saturation, outer volume suppression, one-dimensional projection navigators, and a segmented stack of spirals acquisition. The 3D FB-LGE and 2D BH-LGE scans were performed on 29 cardiac patients. Qualitative analysis and quantitative analysis (in patients with scar) were performed. RESULTS No significant differences were noted between the 3D FB-LGE and 2D BH-LGE data sets in terms of overall image quality score (2D: 4.69 ± 0.60 versus 3D: 4.55 ± 0.51, P = 0.46) and image artifact score (2D: 1.10 ± 0.31 versus 3D: 1.17 ± 0.38; P = 0.63). The average difference in fractional scar volume between the 3D and 2D methods was 1.9% (n = 5). Acquisition time was significantly shorter for the 3D FB-LGE over 2D BH-LGE by a factor of 2.83 ± 0.77 (P < 0.0001). CONCLUSIONS The 3D FB-LGE is a viable option for patients, particularly in acute settings or in patients who are unable to comply with breath-hold instructions. Magn Reson Med 77:1533-1543, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Rajiv G Menon
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland, USA
| | - G Wilson Miller
- Department of Radiology & Medical Imaging, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jean Jeudy
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Taehoon Shin
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, Baltimore, Maryland, USA
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Yerly J, Ginami G, Nordio G, Coristine AJ, Coppo S, Monney P, Stuber M. Coronary endothelial function assessment using self-gated cardiac cine MRI andk-tsparse SENSE. Magn Reson Med 2015; 76:1443-1454. [DOI: 10.1002/mrm.26050] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 09/30/2015] [Accepted: 10/23/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Jérôme Yerly
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
| | - Giulia Ginami
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
| | - Giovanna Nordio
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
| | - Andrew J. Coristine
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
| | - Simone Coppo
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
| | - Pierre Monney
- Cardiac MR Center, Service of Cardiology; University Hospital of Lausanne; Lausanne Switzerland
| | - Matthias Stuber
- Department of Radiology; University Hospital and University of Lausanne; Lausanne Switzerland
- Center for Biomedical Imaging; Lausanne Switzerland
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Celeng C, Vadvala H, Puchner S, Pursnani A, Sharma U, Kovacs A, Maurovich-Horvat P, Hoffmann U, Ghoshhajra B. Defining the optimal systolic phase targets using absolute delay time for reconstructions in dual-source coronary CT angiography. Int J Cardiovasc Imaging 2015; 32:91-100. [PMID: 26335369 DOI: 10.1007/s10554-015-0755-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 08/26/2015] [Indexed: 10/23/2022]
Abstract
To define the optimal systolic phase for dual-source computed tomography angiography using an absolute reconstruction delay time after the R-R interval based on the coronary artery motion, we analyzed images reconstructed between 200 and 420 miliseconds (ms) after the R wave at 20 ms increments in 21 patients. Based on the American Heart Association coronary segmentation guidelines, the origin of six coronary artery landmarks (RCA, AM1, PDA, LM, OM1, and D2) were selected to calculate the coronary artery motion velocity. The velocity of the given landmark was defined as the quotient of the route and the length of the time interval. The x, y and z-coordinates of the selected landmark were recorded, and were used for the calculation of the 3D route of coronary artery motion by using a specific equation. Differences in velocities were assessed by analysis of variance for repeated measures; Bonferroni post hoc tests were used for multiple pair wise comparisons. 1488 landmarks were measured (6 locations at 12 systolic time points) in 21 patients and were analyzed. The mean values of the minimum velocities were calculated separately for each heart rate group (i.e. <65; 65-80; and >80 bpm). The mean lowest coronary artery velocities in each segment occurred in the middle period of each time interval of the acquired systolic phase i.e. 280-340 ms. No differences were found in the minimal coronary artery velocities between the three HR groups, with the exception of the AM1 branch (p = 0.00495) between <65 and >80 bpm (p = 0.03), and at HRs of 65-80 versus >80 bpm (p = 0.006). During an absolute delay of 200-420 ms after the R-wave, the ideal reconstruction interval varies significantly among coronary artery segments. Decreased velocities occur between 280 to 340 ms. Therefore a narrow range of systolic intervals, rather than a single phase, should be acquired.
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Affiliation(s)
- Csilla Celeng
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. .,MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Varosmajor Street, 1122, Budapest, Hungary.
| | - Harshna Vadvala
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Stefan Puchner
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Amit Pursnani
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Umesh Sharma
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Attila Kovacs
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Varosmajor Street, 1122, Budapest, Hungary.
| | - Pâl Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, 68 Varosmajor Street, 1122, Budapest, Hungary.
| | - Udo Hoffmann
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Brian Ghoshhajra
- Cardiovascular Imaging, Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
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10
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Coppo S, Piccini D, Bonanno G, Chaptinel J, Vincenti G, Feliciano H, van Heeswijk RB, Schwitter J, Stuber M. Free-running 4D whole-heart self-navigated golden angle MRI: Initial results. Magn Reson Med 2014; 74:1306-16. [PMID: 25376772 DOI: 10.1002/mrm.25523] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/01/2014] [Accepted: 10/16/2014] [Indexed: 12/22/2022]
Abstract
PURPOSE To test the hypothesis that both coronary anatomy and ventricular function can be assessed simultaneously using a single four-dimensional (4D) acquisition. METHODS A free-running 4D whole-heart self-navigated acquisition incorporating a golden angle radial trajectory was implemented and tested in vivo in nine healthy adult human subjects. Coronary magnetic resonance angiography (MRA) datasets with retrospective selection of acquisition window width and position were extracted and quantitatively compared with baseline self-navigated electrocardiography (ECG) -triggered coronary MRA. From the 4D datasets, the left-ventricular end-systolic, end-diastolic volumes (ESV & EDV) and ejection fraction (EF) were computed and compared with values obtained from conventional 2D cine images. RESULTS The 4D datasets enabled dynamic assessment of the whole heart with isotropic spatial resolution of 1.15 mm(3). Coronary artery image quality was very similar to that of the ECG-triggered baseline scan despite some SNR penalty. A good agreement between 4D and 2D cine imaging was found for EDV, ESV, and EF. CONCLUSION The hypothesis that both coronary anatomy and ventricular function can be assessed simultaneously in vivo has been tested positive. Retrospective and flexible acquisition window selection allows to best visualize each coronary segment at its individual time point of quiescence.
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Affiliation(s)
- Simone Coppo
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Davide Piccini
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare IM BM PI, Lausanne, Switzerland
| | - Gabriele Bonanno
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jérôme Chaptinel
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Gabriella Vincenti
- Department of Cardiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Hélène Feliciano
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Juerg Schwitter
- Department of Cardiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Matthias Stuber
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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11
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Coppo S, Firsova M, Locca D, Knebel JF, van Heeswijk RB, Stuber M. Repositioning precision of coronary arteries measured on X-ray angiography and its implications for coronary MR angiography. J Magn Reson Imaging 2014; 41:1251-8. [DOI: 10.1002/jmri.24685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 06/11/2014] [Accepted: 06/11/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
- Simone Coppo
- Center for Biomedical Imaging (CIBM); Lausanne Switzerland
- Department of Radiology; University Hospital (CHUV) and University of Lausanne (UNIL); Lausanne Switzerland
| | - Maria Firsova
- Center for Biomedical Imaging (CIBM); Lausanne Switzerland
- Department of Radiology; University Hospital (CHUV) and University of Lausanne (UNIL); Lausanne Switzerland
| | - Didier Locca
- Department of Cardiology; University Hospital (CHUV); Lausanne Switzerland
- Barts and The London Chest Hospital; Queen Mary University London; London United Kingdom
| | - Jean-François Knebel
- Neuropsychology and Neurorehabilitation Service, DNC; University Hospital (CHUV) and University of Lausanne (UNIL); Lausanne Switzerland
- NCCR “SYNAPSY - The Synaptic Bases of Mental Diseases”; Lausanne Switzerland
| | - Ruud B. van Heeswijk
- Center for Biomedical Imaging (CIBM); Lausanne Switzerland
- Department of Radiology; University Hospital (CHUV) and University of Lausanne (UNIL); Lausanne Switzerland
| | - Matthias Stuber
- Center for Biomedical Imaging (CIBM); Lausanne Switzerland
- Department of Radiology; University Hospital (CHUV) and University of Lausanne (UNIL); Lausanne Switzerland
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12
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Groarke JD, Waller AH, Vita TS, Michaud GF, Di Carli MF, Blankstein R, Kwong RY, Steigner M. Feasibility study of electrocardiographic and respiratory gated, gadolinium enhanced magnetic resonance angiography of pulmonary veins and the impact of heart rate and rhythm on study quality. J Cardiovasc Magn Reson 2014; 16:43. [PMID: 24947763 PMCID: PMC4078012 DOI: 10.1186/1532-429x-16-43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 05/23/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND We aimed to assess the feasibility of 3 dimensional (3D) respiratory and ECG gated, gadolinium enhanced magnetic resonance angiography (MRA) on a 3 Tesla (3 T) scanner for imaging pulmonary veins (PV) and left atrium (LA). The impact of heart rate (HR) and rhythm irregularity associated with atrial fibrillation (AF) on image and segmentation qualities were also assessed. METHODS 101 consecutive patients underwent respiratory and ECG gated (ventricular end systolic window) MRA for pre AF ablation imaging. Image quality (assessed by PV delineation) was scored as 1 = not visualized, 2 = poor, 3 = good and 4 = excellent. Segmentation quality was scored on a similar 4 point scale. Signal to noise ratios (SNRs) were calculated for the LA, LA appendage (LAA), and PV. Contrast to noise ratios (CNRs) were calculated between myocardium and LA, LAA and PV, respectively. Associations between HR/rhythm and quality metrics were assessed. RESULTS 35 of 101 (34.7%) patients were in AF at time of MRA. 100 (99%) patients had diagnostic studies, and 91 (90.1%) were of good or excellent quality. Overall, mean ± standard deviation (SD) image quality score was 3.40 ± 0.69. Inter observer agreement for image quality scores was substantial, (kappa = 0.68; 95% confidence interval (CI): 0.46, 0.90). Neither HR adjusting for rhythm [odds ratio (OR) = 1.03, 95% CI = 0.98,1.09; p = 0.22] nor rhythm adjusting for HR [OR = 1.25, 95% CI = 0.20, 7.69; p = 0.81] demonstrated association with image quality. Similarly, SNRs and CNRs were largely independent of HR after adjusting for rhythm. Segmentation quality scores were good or excellent for 77.3% of patients: mean ± SD score = 2.91 ± 0.63, and scores did not significantly differ by baseline rhythm (p = 0.78). CONCLUSIONS 3D respiratory and ECG gated, gadolinium enhanced MRA of the PVs and LA on a 3 T system is feasible during ventricular end systole, achieving high image quality and high quality image segmentation when imported into electroanatomic mapping systems. Quality is independent of HR and heart rhythm for this free breathing, radiation free, alternative strategy to current MRA or CT based approaches, for pre AF ablation imaging of PVs and LA.
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Affiliation(s)
- John D Groarke
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alfonso H Waller
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Tomas S Vita
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory F Michaud
- Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marcelo F Di Carli
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ron Blankstein
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Raymond Y Kwong
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Steigner
- Cardiovascular Imaging Program, Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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13
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Shin T, Hu BS, Nishimura DG. Off-resonance-robust velocity-selective magnetization preparation for non-contrast-enhanced peripheral MR angiography. Magn Reson Med 2013; 70:1229-40. [PMID: 23192893 PMCID: PMC3594489 DOI: 10.1002/mrm.24561] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 10/23/2012] [Accepted: 10/24/2012] [Indexed: 11/09/2022]
Abstract
PURPOSE To develop a new velocity-selective (VS) excitation pulse sequence which is robust to field inhomogeneity, and demonstrate its application to non-contrast-enhanced peripheral MR angiography (MRA). METHODS The off-resonance-robust VS saturation pulse is designed by incorporating 180° refocusing pulses into the k-space-based reference design and tailoring sequence parameters in a velocity region of interest. The VS saturation pulse is used as magnetization preparation for non-contrast-enhanced peripheral MRA to suppress background tissues but not arterial blood based on their velocities. Non-contrast-enhanced peripheral MRA using the proposed VS preparation was tested in healthy volunteers and a patient with arterial stenosis. RESULTS Calf angiograms obtained using the new VS preparation show more uniform background suppression than the reference VS preparation, as demonstrated by larger mean values and smaller standard deviations of artery-to-vein and artery-to-muscle contrast-to-noise ratios (71.0 ± 11.4 and 75.3 ± 12.1 versus 61.7 ± 22.7 and 58.5 ± 27.8). Two-station peripheral MRA using the new VS preparation identifies stenosis of the femoral and popliteal arteries in the patient, as validated by digital subtraction angiography. CONCLUSION Non-contrast-enhanced MRA using the new VS magnetization preparation can reliably provide high angiographic contrast in the lower extremities with significantly improved immunity to field inhomogeneity.
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Affiliation(s)
- Taehoon Shin
- Department of Electrical Engineering, Stanford University, Stanford, California
| | - Bob S. Hu
- Department of Electrical Engineering, Stanford University, Stanford, California
- Palo Alto Medical Foundation, Palo Alto, California
- Heart Vista Inc., Palo Alto, California
| | - Dwight G. Nishimura
- Department of Electrical Engineering, Stanford University, Stanford, California
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14
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Raman FS, Nacif MS, Cater G, Gai N, Jones J, Li D, Sibley CT, Liu S, Bluemke DA. 3.0-T whole-heart coronary magnetic resonance angiography: comparison of gadobenate dimeglumine and gadofosveset trisodium. Int J Cardiovasc Imaging 2013; 29:1085-94. [PMID: 23515949 PMCID: PMC3702681 DOI: 10.1007/s10554-013-0192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/30/2013] [Indexed: 10/27/2022]
Abstract
Gadolinium enhanced coronary magnetic resonance angiography (MRA) at 3 T appears to be superior to non-contrast methods. Gadofosveset is an intravascular contrast agent that may be well suited to this application. The purpose of this study was to perform an intra-individual comparison of gadofosveset and gadobenate for coronary MRA at 3 T. In this prospective randomized study, 22 study subjects [8 (36%) male; 27.9 ± 6 years; BMI = 22.8 ± 2 kg/m(2)] underwent two studies using a contrast-enhanced inversion recovery three-dimensional fast low angle shot MRA at 3 T. The order of contrast agent administration was varied randomly, separated by an average of 30 ± 5 days, using either gadobenate dimeglumine (Gd-BOPTA; Bracco, 0.1 mmol/Kg) or gadofosveset trisodium (MS-325; Lantheus Med, 0.03 mmol/Kg). Acquisition time, signal-to-noise ratio (SNR) of coronary vessels and contrast-to-noise ratio (CNR) were evaluated. Of 308 coronary arteries and veins segment analyzed, overall SNR of coronary arteries and veins segments were not different for the two contrast agents (132 ± 79 for gadofosveset vs. 135 ± 78 for gadobenate, p = 0.69). Coronary artery CNR was greater for gadofosveset in comparison to gadobenate (73.5 ± 46.9 vs. 59.3 ± 75.7 respectively, p = 0.03). Gadofosveset-enhanced MRA images displayed better image quality than gadobenate-enhanced MRA images (2.77 ± 0.61 for gadofosveset vs. 2.11 ± 0.51, p < .001). Inter- and intra-reader variability was excellent (ICC > 0.90) for both contrast agents. Gadofosveset trisodium appears to show slightly better performance for coronary MRA at 3 T compared to gadobenate.
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Affiliation(s)
- Fabio S Raman
- Radiology and Imaging Sciences, National Institutes of Health of Clinical Center, 10 Center Drive, Building 10, Rm 1C355, Bethesda, MD 20892-1182, USA
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15
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Ahmed N, Carrick D, Layland J, Oldroyd KG, Berry C. The role of cardiac magnetic resonance imaging (MRI) in acute myocardial infarction (AMI). Heart Lung Circ 2013; 22:243-55. [PMID: 23279917 DOI: 10.1016/j.hlc.2012.11.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Revised: 11/10/2012] [Accepted: 11/12/2012] [Indexed: 12/17/2022]
Abstract
Acute myocardial infarction (AMI) is a leading cause of mortality and morbidity in the world, despite the rate having significantly declined over the past decade. The aim of this review is to consider the emerging diagnostic and clinical utility of cardiac MRI in patients with recent AMI. Cardiac MRI has high reproducibility and accuracy, allowing detailed functional assessment and characterisation of myocardial tissue. In addition to traditional measures including infarct size (IS), transmural extent of necrosis and microvascular obstruction (MVO), other infarct characteristics can now be identified using innovative MRI techniques. These novel pathologies include myocardial oedema and myocardial haemorrhage which also have functional and prognostic implications for patients. In addition to its diagnostic utility in ordinary clinical practice, cardiac MRI has been increasingly used to provide information on surrogate outcome measures, such as left ventricular ejection fraction (LVEF) and volumes, in clinical trials. MRI is becoming more available in secondary care, however, the potential clinical utility and cost effectiveness of MRI in post-MI patients remains uncertain. Cardiac MRI is most likely to be useful in high risk patients with risk factors for heart failure (HF). This includes individuals with early signs of pump failure and risk factors for adverse remodelling, such as MVO. This review focuses on the role of cardiac MRI in the assessment of patients with AMI.
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Affiliation(s)
- Nadeem Ahmed
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, G12 8QQ, Scotland, UK
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16
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Gharib AM, Abd-Elmoniem KZ, Pettigrew RI, Hadigan C. Noninvasive coronary imaging for atherosclerosis in human immunodeficiency virus infection. Curr Probl Diagn Radiol 2011; 40:262-7. [PMID: 21939819 PMCID: PMC3181085 DOI: 10.1067/j.cpradiol.2011.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Coronary artery disease is increasingly recognized as an important contributor to morbidity and mortality among persons living with human immunodeficiency virus (HIV) infection. Traditional cardiovascular disease risk factors as well as aspects of HIV infection and its therapy contribute to the increased coronary artery disease observed in HIV. Advances in noninvasive imaging methodologies in both computed tomography and magnetic resonance imaging provide opportunities to evaluate coronary artery atherosclerosis in ways not possible by conventional invasive x-ray angiography. Application of these techniques may prove very useful in the study of atherosclerosis in many diseases, such as HIV.
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Affiliation(s)
- Ahmed M Gharib
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
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17
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Gweon HM, Kim SJ, Lee SM, Hong YJ, Kim TH. 3D whole-heart coronary MR angiography at 1.5T in healthy volunteers: comparison between unenhanced SSFP and Gd-enhanced FLASH sequences. Korean J Radiol 2011; 12:679-85. [PMID: 22043149 PMCID: PMC3194771 DOI: 10.3348/kjr.2011.12.6.679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 06/03/2011] [Indexed: 11/18/2022] Open
Abstract
Objective To validate the optimal cardiac phase and appropriate acquisition window for three-dimensional (3D) whole-heart coronary magnetic resonance angiography (MRA) with a steady-state free precession (SSFP) sequence, and to compare image quality between SSFP and Gd-enhanced fast low-angle shot (FLASH) MR techniques at 1.5 Tesla (T). Materials and Methods Thirty healthy volunteers (M:F = 25:5; mean age, 35 years; range, 24-54 years) underwent a coronary MRA at 1.5T. 3D whole-heart coronary MRA with an SSFP was performed at three different times: 1) at end-systole with a narrow (120-msec) acquisition window (ESN), 2) mid-diastole with narrow acquisition (MDN); and 3) mid-diastole with wide (170-msec) acquisition (MDW). All volunteers underwent a contrast enhanced coronary MRA after undergoing an unenhanced 3D true fast imaging with steady-state precession (FISP) MRA three times. A contrast enhanced coronary MRA with FLASH was performed during MDN. Visibility of the coronary artery and image quality were evaluated for 11 segments, as suggested by the American Heart Association. Image quality was scored by a five-point scale (1 = not visible to 5 = excellent). The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were evaluated at the proximal coronary arteries. Results The SSFP sequence rendered higher visibility coronary segments, higher image quality, as well as higher SNR and CNR than the Gd-enhanced FLASH technique at 1.5T (p < 0.05). The visibility of coronary segments, image quality, SNR and CNR in the ESN, MDN and MDW with SSFP sequence did not differ significantly. Conclusion An SSFP sequence provides an excellent method for the 3D whole-heart coronary MRA at 1.5T. Contrast enhanced coronary MRA using the FLASH sequence does not help improve the visibility of coronary segments, image quality, SNR or CNR on the 3D whole-heart coronary MRA.
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Affiliation(s)
- Hye Mi Gweon
- Department of Radiology and Research Institute of Radiological Science, Yonsei University Health System, Seoul 135-720, Korea
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18
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Jansen CHP, Perera D, Makowski MR, Wiethoff AJ, Phinikaridou A, Razavi RM, Marber MS, Greil GF, Nagel E, Maintz D, Redwood S, Botnar RM. Detection of intracoronary thrombus by magnetic resonance imaging in patients with acute myocardial infarction. Circulation 2011; 124:416-24. [PMID: 21747055 DOI: 10.1161/circulationaha.110.965442] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Persistent intracoronary thrombus after plaque rupture is associated with an increased risk of subsequent myocardial infarction and mortality. Coronary thrombus is usually visualized invasively by x-ray coronary angiography. Non-contrast-enhanced T1-weighted magnetic resonance (MR) imaging has been useful for direct imaging of carotid thrombus and intraplaque hemorrhage by taking advantage of the short T1 of methemoglobin present in acute thrombus and intraplaque hemorrhage. The aim of this study was to investigate the use of non-contrast-enhanced MR for direct thrombus imaging (MRDTI) in patients with acute myocardial infarction. METHODS AND RESULTS Eighteen patients (14 men; age, 61±9 years) underwent MRDTI within 24 to 72 hours of presenting with an acute coronary syndrome before invasive x-ray coronary angiography; MRDTI was performed with a T1-weighted, 3-dimensional, inversion-recovery black-blood gradient-echo sequence without contrast administration. Ten patients were found to have intracoronary thrombus on x-ray coronary angiography (left anterior descending, 4; left circumflex, 2; right coronary artery, 4; and right coronary artery-posterior descending artery, 1), and 8 had no visible thrombus. We found that MRDTI correctly identified thrombus in 9 of 10 patients (sensitivity, 91%; posterior descending artery thrombus not detected) and correctly classified the control group in 7 of 8 patients without thrombus formation (specificity, 88%). The contrast-to-noise ratio was significantly greater in coronary segments containing thrombus (n=10) compared with those without visible thrombus (n=131; mean contrast-to-noise ratio, 15.9 versus 2.6; P<0.001). CONCLUSION Use of MRDTI allows selective visualization of coronary thrombus in a patient population with a high probability of intracoronary thrombosis.
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Affiliation(s)
- C H P Jansen
- Division of Imaging Sciences, The Rayne Institute, St. Thomas' Hospital, King's College London, London, UK.
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19
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Liew GYH, Feneley M, Worthley SG. Noninvasive Coronary Artery Imaging: Current Clinical Applications. Heart Lung Circ 2011; 20:425-37. [PMID: 21530393 DOI: 10.1016/j.hlc.2010.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Accepted: 12/13/2010] [Indexed: 01/01/2023]
Affiliation(s)
- Gary Y H Liew
- Cardiovascular Investigation Unit, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
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20
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Uribe S, Hussain T, Valverde I, Tejos C, Irarrazaval P, Fava M, Beerbaum P, Botnar RM, Razavi R, Schaeffter T, Greil GF. Congenital heart disease in children: coronary MR angiography during systole and diastole with dual cardiac phase whole-heart imaging. Radiology 2011; 260:232-40. [PMID: 21493790 DOI: 10.1148/radiol.11101659] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the optimal timing for coronary magnetic resonance (MR) angiography in children with congenital heart disease by using dual cardiac phase whole-heart MR imaging. MATERIALS AND METHODS The local institutional review board approved this study, and informed consent was obtained from parents or guardians. Thirty children (13 girls; overall mean age, 5.01 years) were examined with a 1.5-T MR system. A free-breathing three-dimensional steady-state free precession dual cardiac phase sequence was used to obtain MR angiographic data during end-systolic and middiastolic rest periods. Vessel length, diameter, and sharpness, as well as image quality of the coronary artery segments, were analyzed and compared by using Bland-Altman plots, linear regression analysis, the t test, and Wilcoxon signed rank tests. RESULTS Optimal coronary artery imaging timing was patient dependent and different for each coronary artery segment (36 segments favored end systole, 28 favored middiastole). In 15 patients (50%), different segments favored different cardiac phases within the same patient. Image quality and vessel sharpness degraded with higher heart rates, with a similar correlation for end systole (right coronary artery [RCA], 0.39; left main [LM] coronary artery, 0.46; left anterior descending [LAD] artery, 0.51; and left circumflex [LCX] artery, 0.50) and middiastole (RCA, 0.34; LM, 0.45; LAD, 0.48; and LCx, 0.55). Mean image quality difference or mean vessel sharpness difference showed no indication to prefer a specific cardiac phase. CONCLUSION The optimal cardiac rest period for coronary MR angiography in children with congenital heart disease is specific for each coronary artery segment. Dual cardiac phase whole-heart coronary MR angiography enables optimal coronary artery visualization by retrospectively choosing the optimal imaging rest period.
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Affiliation(s)
- Sergio Uribe
- Department of Radiology, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 8330024, Chile.
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21
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Tangcharoen T, Bell A, Hegde S, Hussain T, Beerbaum P, Schaeffter T, Razavi R, Botnar RM, Greil GF. Detection of coronary artery anomalies in infants and young children with congenital heart disease by using MR imaging. Radiology 2011; 259:240-7. [PMID: 21325034 DOI: 10.1148/radiol.10100828] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the feasibility and accuracy of magnetic resonance (MR) coronary angiography for the detection of coronary artery anomalies in infants and children by using surgical findings as a reference. MATERIALS AND METHODS The data analysis was approved by the institutional review board. One hundred children with congenital heart disease underwent MR coronary angiography while under general anesthesia (mean age ± standard deviation, 3.9 years ± 3; age range, 0.2-11 years). A navigator-gated, T2-prepared, three-dimensional steady-state free precession whole-heart protocol (isotropic voxel size, 1.0-1.3 mm(3); mean imaging time, 4.6 minutes ± 1.2; mean navigator efficiency, 70%; 3-mm gating window) was used after injection of gadopentetate dimeglumine. The cardiac rest period (end systole or middiastole) and acquisition window were prospectively assessed for each patient. Coronary artery image quality (score of 0 [nondiagnostic] to 4 [excellent]), vessel sharpness, and coronary artery anomalies were assessed by two observers. Surgery was performed in 58 patients, and those findings were used to define accuracy. Variables were assessed between age groups by using either analysis of variance or Kruskal-Wallis tests. RESULTS Diagnostic image quality (score, ≥1 for all coronary artery segments) was obtained in 46 of the 58 patients (79%) who underwent surgery. The origin and course of the coronary artery anatomy depicted with MR imaging was confirmed at surgery in all 46 patients-including the four (9%) with substantial coronary artery anomalies. Diagnostic-quality images were obtained in 84 of the 100 patients. The rate of success improved significantly when patients were older than 4 months (88% for patients >4 months vs 17% for patients ≤4 months, P < .001). CONCLUSION Improved whole-heart MR coronary angiography enables accurate detection of abnormal origin and course of the coronary artery system even in very young patients with congenital heart disease.
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Affiliation(s)
- Tarinee Tangcharoen
- Division of Imaging Sciences, Guy's and St Thomas' Hospital, The Rayne Institute, King's College London, 4th Floor, Lambeth Wing, London SE1 7EH, England
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22
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Yamamura J, Frisch M, Ecker H, Graessner J, Hecher K, Adam G, Wedegärtner U. Self-gating MR imaging of the fetal heart: comparison with real cardiac triggering. Eur Radiol 2010; 21:142-9. [PMID: 20676652 DOI: 10.1007/s00330-010-1911-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 06/04/2010] [Accepted: 06/14/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the self-gating technique for MR imaging of the fetal heart in a sheep model. MATERIAL AND METHODS MR images of 6 fetal sheep heart were obtained at 1.5 T. For self-gating MRI of the fetal heart a cine SSFP in short axis, two and four chamber view was used. Self-gated images were compared with real cardiac triggered MR images (pulse-wave triggering). MRI of the fetal heart was performed using both techniques simultaneously. Image quality was assessed and the left ventricular volume and function were measured and compared. RESULTS Compared with pulse-wave triggering, the self-gating technique produced slightly inferior images with artifacts. Especially the atrial septum could not be so clearly depicted. The contraction of the fetal heart was shown in cine sequences in both techniques. The average blood volumes could be measured with both techniques with no significant difference: at end-systole 3.1 ml (SD±0.2), at end-diastole 4.9 ml (±0.2), with ejection fractions at 38.6%, respectively 39%. CONCLUSION Both self-gating and pulse-wave triggered cardiac MRI of the fetal heart allowed the evaluation of anatomical structures and functional information. Images obtained by self-gating technique were slightly inferior than the pulse-wave triggered MRI.
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Affiliation(s)
- Jin Yamamura
- Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
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Shin T, Pohost GM, Nayak KS. Systolic 3D first-pass myocardial perfusion MRI: Comparison with diastolic imaging in healthy subjects. Magn Reson Med 2010; 63:858-64. [PMID: 20373386 DOI: 10.1002/mrm.22315] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Three-dimensional (3D) first-pass myocardial perfusion imaging (MPI) is a promising alternative to conventional two-dimensional multislice MPI due to its contiguous spatial coverage that is beneficial for estimating the size of perfusion defects. Data acquisition at mid-diastole is a typical choice for 3D MPI yet is sensitive to arrhythmia and variations in R-R interval that are common in cardiac patients. End systole is the second longest quiescent cardiac phase and is known to be less sensitive to the R-R variability. Therefore, 3D MPI with systolic acquisition may be advantageous in patients with severe arrhythmia once it is proven to be comparable to diastolic MPI in subjects with negligible R-R variation. In this work, we demonstrate the feasibility of 3D MPI with systolic data acquisition in five healthy subjects. We performed 3D MPI experiments in which 3D perfusion data were acquired at both end-systole and mid-diastole of every R-R interval and analyzed the similarity between resulting time intensity curves (TIC) from the two data sets. The correlation between systolic and diastolic TICs was extremely high (mean = 0.9841; standard deviation = 0.0166), and there was a significant linear correlation between the two time intensity curve upslopes and peak enhancements (P < 0.001).
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Affiliation(s)
- Taehoon Shin
- Ming Hsieh Department of Electrical Engineering, University of Southern California, Los Angeles, California, USA.
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24
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High Field Cardiac Magnetic Resonance Imaging – Current and Future Perspectives. Heart Lung Circ 2010; 19:145-53. [DOI: 10.1016/j.hlc.2009.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 11/26/2009] [Accepted: 11/29/2009] [Indexed: 01/18/2023]
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25
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van Elderen SGC, van Elderen SGC, Versluis MJ, Webb AG, Westenberg JJM, Doornbos J, Smith NB, de Roos A, Stuber M. Initial results on in vivo human coronary MR angiography at 7 T. Magn Reson Med 2010; 62:1379-84. [PMID: 19859918 DOI: 10.1002/mrm.22168] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Seven tesla (T) MR imaging is potentially promising for the morphologic evaluation of coronary arteries because of the increased signal-to-noise ratio compared to lower field strengths, in turn allowing improved spatial resolution, improved temporal resolution, or reduced scanning times. However, there are a large number of technical challenges, including the commercial 7 T systems not being equipped with homogeneous body radiofrequency coils, conservative specific absorption rate constraints, and magnified sample-induced amplitude of radiofrequency field inhomogeneity. In the present study, an initial attempt was made to address these challenges and to implement coronary MR angiography at 7 T. A single-element radiofrequency transmit and receive coil was designed and a 7 T specific imaging protocol was implemented, including significant changes in scout scanning, contrast generation, and navigator geometry compared to current protocols at 3 T. With this methodology, the first human coronary MR images were successfully obtained at 7 T, with both qualitative and quantitative findings being presented.
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26
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Improved SNR efficiency in gradient echo coronary MRA with high temporal resolution using parallel imaging. Magn Reson Med 2009; 62:1211-20. [DOI: 10.1002/mrm.22114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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27
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Abstract
Coronary MR imaging is a promising noninvasive technique for the combined assessment of coronary artery anatomy and function. Anomalous coronary arteries and aneurysms can reliably be assessed in clinical practice using coronary MR imaging and the presence of significant left main or proximal multivessel coronary artery disease detected. Technical challenges that need to be addressed are further improvements in motion suppression and abbreviated scanning times aimed at improving spatial resolution and patient comfort. The development of new and specific contrast agents, high-field MR imaging with improved spatial resolution, and continued progress in MR imaging methods development will undoubtedly lead to further progress toward the noninvasive and comprehensive assessment of coronary atherosclerotic disease.
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Affiliation(s)
- Sebastian Kelle
- Division of Cardiology, Department of Medicine, German Heart Institute, Berlin, Germany; Division of Magnetic Resonance Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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28
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High resolution MR imaging of the fetal heart with cardiac triggering: a feasibility study in the sheep fetus. Eur Radiol 2009; 19:2383-90. [DOI: 10.1007/s00330-009-1420-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 03/02/2009] [Accepted: 03/18/2009] [Indexed: 10/20/2022]
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Gamble JHP, Scott G, Ormerod JOM, Frenneaux MP. Pathophysiology of coronary artery disease: the case for multiparametric imaging. Expert Rev Cardiovasc Ther 2009; 7:299-310. [PMID: 19296768 DOI: 10.1586/14779072.7.3.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Interventions to treat coronary artery disease are available but they must be targeted at the correct individuals (and indeed lesions), in order to gain maximal benefit with the minimal adverse effects. Coronary contrast angiography is not able to provide all the information required for the assessment of the effects of artery disease. Other imaging modalities are of growing importance as they can reduce radiation exposure and invasiveness of screening, as well as providing important extra information. The ideal 'multiparametric' imaging technique would assess anatomy, viability and lesion activity in a single quick scan. Currently, MRI is the technology closest to achieving this ideal, although the existing technology still has some limitations. This review discusses the currently available techniques for the imaging of coronary anatomy and of myocardial viability, and considers their benefits and limitations. We also discuss the developing field of imaging molecularly targeted to active coronary lesions. Finally we provide a 5-year view of the current and likely future optimal imaging strategies.
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Affiliation(s)
- James H P Gamble
- Department of Medicine, Royal Berkshire Hospital, Reading, Berkshire, UK.
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30
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Bibliography. Current world literature. Diseases of the aorta, pulmonary, and peripheral vessels. Curr Opin Cardiol 2008; 23:646-7. [PMID: 18830082 DOI: 10.1097/hco.0b013e328316c259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Gharib AM, Elagha A, Pettigrew RI. Cardiac magnetic resonance at high field: promises and problems. Curr Probl Diagn Radiol 2008; 37:49-56. [PMID: 18295076 DOI: 10.1067/j.cpradiol.2007.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiac magnetic resonance imaging (CMRI) at high magnetic field (3 Tesla) is rapidly evolving with many promising results. However, the challenges of field inhomogeneities and specific absorption rate limitations need to be addressed before reaping the benefits of high magnetic field for CMRI. This review focuses on the methods to overcome some of these challenges and the current and potential applications of this technology.
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Affiliation(s)
- Ahmed M Gharib
- Diagnostic Radiology Department and NHLBI, National Institutes of Health, Bethesda, MD 20892, USA.
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32
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Kozerke S, Plein S. Accelerated CMR using zonal, parallel and prior knowledge driven imaging methods. J Cardiovasc Magn Reson 2008; 10:29. [PMID: 18534005 PMCID: PMC2426690 DOI: 10.1186/1532-429x-10-29] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Accepted: 06/05/2008] [Indexed: 11/17/2022] Open
Abstract
Accelerated imaging is highly relevant for many CMR applications as competing constraints with respect to spatiotemporal resolution and tolerable scan times are frequently posed. Three approaches, all involving data undersampling to increase scan efficiencies, are discussed in this review. Zonal imaging can be considered a niche but nevertheless has found application in coronary imaging and CMR flow measurements. Current work on parallel-transmit systems is expected to revive the interest in zonal imaging techniques. The second and main approach to speeding up CMR sequences has been parallel imaging. A wide range of CMR applications has benefited from parallel imaging with reduction factors of two to three routinely applied for functional assessment, perfusion, viability and coronary imaging. Large coil arrays, as are becoming increasingly available, are expected to support reduction factors greater than three to four in particular in combination with 3D imaging protocols. Despite these prospects, theoretical work has indicated fundamental limits of coil encoding at clinically available magnetic field strengths. In that respect, alternative approaches exploiting prior knowledge about the object being imaged as such or jointly with parallel imaging have attracted considerable attention. Five to eight-fold scan accelerations in cine and dynamic CMR applications have been reported and image quality has been found to be favorable relative to using parallel imaging alone.With all acceleration techniques, careful consideration of the limits and the trade-off between acceleration and occurrence of artifacts that may arise if these limits are breached is required. In parallel imaging the spatially varying noise has to be considered when measuring contrast- and signal-to-noise ratios. Also, temporal fidelity in images reconstructed with prior knowledge driven methods has to be studied carefully.
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Affiliation(s)
- Sebastian Kozerke
- Institute for Biomedical Engineering, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Sven Plein
- Academic Unit of Cardiovascular Medicine, University of Leeds, Leeds, UK
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Wieben O, Francois C, Reeder SB. Cardiac MRI of ischemic heart disease at 3 T: potential and challenges. Eur J Radiol 2008; 65:15-28. [PMID: 18077119 DOI: 10.1016/j.ejrad.2007.10.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2007] [Accepted: 10/30/2007] [Indexed: 12/17/2022]
Abstract
Cardiac MRI has become a routinely used imaging modality in the diagnosis of cardiovascular disease and is considered the clinically accepted gold standard modality for the assessment of cardiac function and myocardial viability. In recent years, commercially available clinical scanners with a higher magnetic field strength (3.0 T) and dedicated multi-element coils have become available. The superior signal-to-noise ratio (SNR) of these systems has lead to their rapid acceptance in cranial and musculoskeletal MRI while the adoption of 3.0 T for cardiovascular imaging has been somewhat slower. This review article describes the benefits and pitfalls of magnetic resonance imaging of ischemic heart disease at higher field strengths. The fundamental changes in parameters such as SNR, transversal and longitudinal relaxation times, susceptibility artifacts, RF (B1) inhomogeneity, and specific absorption rate are discussed. We also review approaches to avoid compromised image quality such as banding artifacts and inconsistent or suboptimal flip angles. Imaging sequences for the assessment of cardiac function with CINE balanced SSFP imaging and MR tagging, myocardial perfusion, and delayed enhancement and their adjustments for higher field imaging are explained in detail along with several clinical examples. We also explore the use of parallel imaging at 3.0 T to improve cardiac imaging by trading the SNR gain for higher field strengths for acquisition speed with increased coverage or improved spatial and temporal resolution. This approach is particularly useful for dynamic applications that are usually limited to the duration of a single breath-hold.
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Affiliation(s)
- Oliver Wieben
- Department of Radiology, University of Wisconsin, Madison, WI 53792-3252, United States.
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Kuhl CK, Träber F, Gieseke J, Drahanowsky W, Morakkabati-Spitz N, Willinek W, von Falkenhausen M, Manka C, Schild HH. Whole-Body High-Field-Strength (3.0-T) MR Imaging in Clinical Practice
Part II. Technical Considerations and Clinical Applications. Radiology 2008; 247:16-35. [DOI: 10.1148/radiol.2471061828] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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35
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Roes SD, Korosoglou G, Schär M, Westenberg JJ, van Osch MJ, de Roos A, Stuber M. Correction for heart rate variability during 3D whole heart MR coronary angiography. J Magn Reson Imaging 2008; 27:1046-53. [DOI: 10.1002/jmri.21361] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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