Circulation, Vol 87, 94-104, Copyright © 1993 by American Heart Association
WJ Manning, W Li, NG Boyle and RR Edelman
BACKGROUND. The ability to image the coronary arteries noninvasively would
represent an advance in patient care. We have developed a magnetic
resonance (MR) angiographic technique that allows the acquisition of
complete images of coronary flow within a single breath- hold. By this
method, the feasibility of noninvasive MR coronary angiography was
evaluated in 25 subjects, including 19 healthy adult volunteers and six
patients after diagnostic coronary angiography. METHODS AND RESULTS.
Noninvasive MR coronary angiography was performed with a fat-suppressed
ECG-gated gradient-echo sequence with k-space segmentation. Overlapping
transverse sections were initially used to image coronary flow, with
oblique images obtained after identification of proximal anatomy. The left
main coronary artery was seen in 24 subjects (96%), with a mean diameter of
4.8 mm (range, 3.4-6.2 mm) and average length of 10 mm (range, 8-14 mm).
The left anterior descending coronary artery was seen in 100% of subjects,
with a mean proximal diameter of 3.6 mm (range, 2.6-4.3 mm) and for an
average length of 44 mm (range, 28-93 mm). The left circumflex coronary
artery was seen in 76% of subjects, with a mean proximal diameter of 3.5 mm
(range, 2.6- 4.3 mm) and for an average length of 25 mm (range, 9-42 mm).
The right coronary artery was also identified in 100% of subjects, with a
mean proximal diameter of 3.7 mm (range, 2.7-5.1 mm) and for an average
length of 58 mm (range, 24-122 mm). Quantitative angiography of normal
proximal segments demonstrated a good correlation with MR-determined lumen
diameters (r = 0.86, p < 0.002). Occluded vessels in patients with
coronary artery disease displayed an absence of flow signal distal to the
occlusion, whereas vessels with significant angiographic stenoses
demonstrated signal loss corresponding to the area of the stenosis, with
visualization of the more distal vessel. CONCLUSIONS: Breath-hold MR
coronary angiography provides visualization of the major epicardial
vessels. In the future, MR coronary angiography may provide a noninvasive
means for the evaluation of patients with known or suspected coronary
artery disease.
ARTICLES
Fat-suppressed breath-hold magnetic resonance coronary angiography
Department of Medicine, Charles A. Dana Research Institute, Boston, MA.
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