Magnetic Resonance Coronary Angiography: Where Are We Today?
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CARDIAC PET, CT, AND MRI (S ACHENBACH, SECTION EDITOR)
Magnetic Resonance Coronary Angiography: Where Are We Today? Amedeo Chiribiri & Rene M. Botnar & Eike Nagel
Published online: 11 January 2013 # The Author(s) 2013. This article is published with open access at Springerlink.com
Abstract Although cardiovascular magnetic resonance allows the non-invasive and radiation free visualization of both the coronary arteries and veins, coronary vessel wall imaging is still undergoing technical development to improve diagnostic quality. Assessment of the coronary vessels is a valuable addition to the analysis of cardiac function, cardiac anatomy, viability and perfusion which magnetic resonance imaging reliably allows. However, cardiac and respiratory motion and the small size of the coronary vessels present a challenge and require several technical solutions for image optimization. Furthermore, the acquisition protocols need to be adapted to the specific clinical question. This review provides an update on the current clinical applications of cardiovascular magnetic resonance coronary angiography, recent technical advances and describes the acquisition protocols in use.
CT CV EPI ICAM-1 LAD LCX MMP MRA MTC RCA SAR SENSE SMASH SNR SSFP USPIO VCAM-1
computed tomography coronary veins echo planar imaging intercellular adhesion molecule - 1 left anterior descending (coronary artery) left circumflex (coronary artery) matrix metalloproteinase magnetic resonance angiography magnetization transfer contrast right coronary artery specific absorption rate sensitivity encoding simultaneous acquisition of spatial harmonics signal-to-noise ratio steady state free precession ultra-small super paramagnetic iron oxide vascular adhesion molecule – 1
Keywords Coronary angiography . Coronary venous system . Gadolinium . Magnetic resonance imaging Introduction List of Abbreviations 2D 2-dimensional 3D 3-dimensional CA contrast agent CAD coronary artery disease CMR cardiovascular magnetic resonance This article is part of the Topical Collection on Cardiac PET, CT, and MRI A. Chiribiri (*) : R. M. Botnar : E. Nagel Division of Imaging Sciences and Biomedical Engineering, King’s College London BHF Centre of Excellence, NIHR Biomedical Research Centre and Wellcome Trust and EPSRC Medical Engineering Centre at Guy’s and St. Thomas’ NHS Foundation Trust, The Rayne Institute, 4th Floor Lambeth Wing, St. Thomas’ Hospital, London SE1 7EH, UK e-mail: [email protected]
Despite substantial improvements in prevention and treatment [1], coronary artery disease (CAD), myocardial infarction and heart failure constitute the leading cause of death in the western world [2]. The current gold standard for the diagnosis of CAD is invasive coronary angiography, but the increasing prevalence of CAD and the relatively reduced diagnostic yield of invasive assessment [3] clearly indicate the need for noninvasive tests that could directly assess the integrity of the coronary lumen [4]. Cardiovascular magnetic resonance (CMR) theoretically provides a combi
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