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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).

View larger version (15K): [in a new window]   Figure 1. The course of the coronary MR angiographic examination. RR = R-R interval (in milliseconds), SENSE = sensitivity encoding, TR = repetition time (in milliseconds).

View larger version (175K): [in a new window]   Figure 2. Images in 69-year-old woman. A, B, Multiplanar reformatted MR images (4.5/2.3, 90° flip angle) of LCA system acquired with NAV and BH (sensitivity encoding factor, 2.7) approaches. Note improved delineation of vessel border of LCA system in NAV image. Increased visibility of the LCX and coronary side branches on the NAV image can be appreciated. C, D, Multiplanar reformatted MR images (4.5/2.3, 90° flip angle) of RCA acquired with BH (sensitivity encoding factor, 2.6) and NAV approaches. Note the improved image quality beyond the crux of the RCA on the NAV image. Ao = aorta, LM = left main artery.

View larger version (130K): [in a new window]   Figure 3. A-C, Images in 72-year-old woman. Both, A, NAV, and, B, BH (sensitivity encoding factor, 2.3) multiplanar reformatted coronary MR angiograms (4.5/2.3, 90° flip angle) show significant stenosis (white arrow) of the middle portion of the LAD artery. C, Conventional coronary angiogram confirms 75% stenosis (arrow) of the LAD artery. Note that the three-dimensional coronary MR angiographic data set displays the findings of biplane conventional coronary angiography in one imaging plane. D-F, Images in 58-year-old man. Both, D, NAV, and, E, BH (sensitivity encoding factor, 2.8) coronary MR angiograms show midarterial stenosis (white arrow) in the identical location in the RCA of the same patient. F, Conventional coronary angiogram shows 75% stenosis (arrow) of the midportion of the RCA. Ao = aorta, Cath = catheter.

View larger version (28K): [in a new window]   Figure 4. Diagram shows classification of patient population into subgroups 1 and 2. Subgroup 1 consisted of patients (pts.) with a relative SNR of 45% or greater, in whom coronary MR angiography with the BH approach was deemed to yield images of reasonable quality. Subgroup 2 consisted of those patients in subgroup 1 in whom BH imaging yielded excellent visualization (visual score = 4).