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Coronary Arteries: MR Angiography with Fast Contrast-enhanced Three-dimensional Breath-hold Imaging—Initial Experience

¹ Department of Internal Medicine II, University of Erlangen-Nürnberg, Östliche Stadtmauerstrasse 29, 91054 Erlangen, Germany (W.K., S.A., D.R., W.M., W.G.D.)
² Siemens Medical Engineering, Erlangen, Germany (G.L.).

View larger version (23K): [in a new window]   Figure 1. Schematic of positioning of the imaging slab for 3D breath-hold imaging. With a craniocaudal extension of 64 mm, usually the proximal and middle segments of the left anterior descending (straight arrow) and left circumflex (arrowhead) coronary arteries and the proximal segment of the right coronary artery (curved arrow) are covered.

View larger version (36K): [in a new window]   Figure 2. Schematic of k-space trajectory with use of a 3D gradient-echo sequence for contrast-enhanced breath-hold MR coronary angiography. Each • and represents a one-dimensional readout period of 256 data points. The measured data (•) consist of Ny = 140 lines and Nz = 16 partitions. By using zero filling (), 32 partitions are reconstructed. Asymmetric encoding is used to increase the spatial resolution in the section-select direction. Every heartbeat, one-half of the line loop is acquired with the first data point starting at the center of k space. ECG = electrocardiographic gating, FS = fat-saturation pulse, SP = saturation pulse, TD = trigger delay.

View larger version (123K): [in a new window]   Figure 3a. (a) Spin-echo turbo FLASH MR image shows contrast enhancement of the left atrium (LA) and the aorta after administration of gadopentetate dimeglumine. A region of interest for signal intensity measurement is placed over the ascending aorta (1). (b) Relative signal intensity (Rel SI) in the ascending aorta over time after contrast agent administration. The contrast material transit time is determined on the basis of the maximum (Max) of the curve.

View larger version (19K): [in a new window]   Figure 3b. (a) Spin-echo turbo FLASH MR image shows contrast enhancement of the left atrium (LA) and the aorta after administration of gadopentetate dimeglumine. A region of interest for signal intensity measurement is placed over the ascending aorta (1). (b) Relative signal intensity (Rel SI) in the ascending aorta over time after contrast agent administration. The contrast material transit time is determined on the basis of the maximum (Max) of the curve.

View larger version (115K): [in a new window]   Figure 4. Transaxial MR image obtained with contrast-enhanced 3D breath-hold imaging. indicates the regions of interest used for signal intensity measurements of the coronary arteries (left main coronary artery, 1) and perivascular tissue (2). The arrow indicates the left anterior descending coronary artery. AO = aorta, PA = pulmonary artery.

View larger version (76K): [in a new window]   Figure 5. Curvilinear multiplanar reconstruction MR image of the right coronary artery (arrow) and the left main and left anterior descending coronary arteries (arrowhead) was obtained in a healthy volunteer, with contrast-enhanced 3D breath-hold imaging.

View larger version (62K): [in a new window]   Figure 6a. (a) Curvilinear multiplanar reconstruction 3D breath-hold and (b) respiratory-gated MR images in a healthy volunteer depict a left anterior descending coronary artery (arrow) without significant stenosis.

View larger version (72K): [in a new window]   Figure 6b. (a) Curvilinear multiplanar reconstruction 3D breath-hold and (b) respiratory-gated MR images in a healthy volunteer depict a left anterior descending coronary artery (arrow) without significant stenosis.

View larger version (80K): [in a new window]   Figure 7a. (a) Curvilinear multiplanar reconstruction 3D breath-hold MR image and (b) corresponding conventional contrast-enhanced angiogram in the right anterior oblique projection depict a severe proximal stenosis (arrow) of the left anterior descending coronary artery.

View larger version (132K): [in a new window]   Figure 7b. (a) Curvilinear multiplanar reconstruction 3D breath-hold MR image and (b) corresponding conventional contrast-enhanced angiogram in the right anterior oblique projection depict a severe proximal stenosis (arrow) of the left anterior descending coronary artery.