HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2323031225v1 232/3/669    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jahnke, C. Articles by Nagel, E. Search for Related Content PubMed PubMed Citation Articles by Jahnke, C. Articles by Nagel, E.

Coronary MR Angiography with Steady-State Free Precession: Individually Adapted Breath-hold Technique versus Free-breathing Technique¹

¹ From the Department of Internal Medicine/Cardiology, German Heart Institute, Berlin, Germany. Received August 1, 2003; revision requested October 3; final revision received December 29; accepted January 15, 2004. Supported by a grant from the Stifterverband für die Deutsche Wissenschaft. C.J. supported by a research grant from the German Cardiac Society. Address correspondence to C.J., Department of Cardiology, University of Freiburg, Hugstetter Str 55, 79106 Freiburg, Germany (e-mail: jahnke@med1.ukl.uni-freiburg.de).

PURPOSE: To compare image quality and coronary artery stenosis detection with breath-hold (BH) and free-breathing navigator-gated (NAV) coronary magnetic resonance (MR) angiography performed with the same imaging sequence (steady-state free precession) and identical spatial resolution in patients suspected of having coronary artery disease.

MATERIALS AND METHODS: Forty consecutive patients suspected of having coronary artery disease underwent steady-state free precession MR imaging of the left or the right coronary artery twice. Correction of breathing motion was performed once with NAV and again with BH. Maximal BH duration and coronary artery rest period were individually determined, and duration of data acquisition was adapted (parallel imaging with different sensitivity encoding factors was used). Quantitative analysis of coronary MR angiography data was performed with multiplanar reformatting software to determine visual score for image quality, vessel sharpness, visible vessel length, and number of visible side branches. Diagnostic accuracy for detection of coronary stenosis of 50% or greater was determined in comparison with results of conventional invasive angiography. The two techniques were compared regarding differences in angiographic parameters with paired Student t testing. ² or Fisher exact testing was used when appropriate.

RESULTS: More coronary artery segments were assessable with NAV than with BH MR angiography (254 [79.4%] vs 143 [44.7%] of 320 segments). Overall sensitivity and specificity with NAV were 72% (26 of 36 segments) and 91.7% (200 of 218 segments), versus 63% (12 of 19 segments) and 82.3% (102 of 124 segments) with BH; NAV enabled correct diagnosis in 13% more segments. BH yielded nondiagnostic images in 14 patients, while NAV yielded diagnostic images in all patients. When these 14 patients were excluded, there was a significant increase in visual score for left (3.0 vs 2.4, P < .01) and right (3.3 vs 3.0, P < .05) coronary arteries and no significant difference in vessel sharpness but significant improvement in visible vessel length in left coronary artery (85.9 vs 71.4 mm, P = .003) and number of visible side branches in left (4.9 vs 3.9, P = .04) and right (2.8 vs 2.4, P = .04) coronary arteries on NAV images as compared with BH images.

CONCLUSION: Free-breathing NAV was superior to BH coronary MR angiography in terms of image quality and diagnostic accuracy of stenosis detection.

© RSNA, 2004

Index terms: Coronary vessels, MR, 54.12142 • Coronary vessels, stenosis or obstruction, 54.76 • Magnetic resonance (MR), motion correction, 54.12142 • Magnetic resonance (MR), vascular studies, 54.12142

This article has been cited by other articles:

				M. Miyazaki and V. S. Lee Nonenhanced MR Angiography Radiology, July 1, 2008; 248(1): 20 - 43. [Abstract] [Full Text] [PDF]

				M. Dewey, F. Teige, D. Schnapauff, M. Laule, A. C. Borges, K.-D. Wernecke, T. Schink, G. Baumann, W. Rutsch, P. Rogalla, et al. Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging. Ann Intern Med, September 19, 2006; 145(6): 407 - 415. [Abstract] [Full Text] [PDF]

				C. Jahnke, I. Paetsch, S. Achenbach, B. Schnackenburg, R. Gebker, E. Fleck, and E. Nagel Coronary MR Imaging: Breath-hold Capability and Patterns, Coronary Artery Rest Periods, and {beta}-Blocker Use Radiology, April 1, 2006; 239(1): 71 - 78. [Abstract] [Full Text] [PDF]

				C. Jahnke, I. Paetsch, K. Nehrke, B. Schnackenburg, R. Gebker, E. Fleck, and E. Nagel Rapid and complete coronary arterial tree visualization with magnetic resonance imaging: feasibility and diagnostic performance Eur. Heart J., November 1, 2005; 26(21): 2313 - 2319. [Abstract] [Full Text] [PDF]