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Kocaoglu M, Pednekar A, Fleck RJ, Dillman JR. Cardiothoracic Magnetic Resonance Angiography. Curr Probl Diagn Radiol 2024; 53:154-165. [PMID: 37891088 DOI: 10.1067/j.cpradiol.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/01/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Catheter-based angiography is regarded as the clinical reference imaging technique for vessel imaging; however, it is invasive and is currently used for intervention or physiologic measurements. Contrast enhanced magnetic resonance angiography (MRA) with gadolinium-based contrast agents can be performed as a three-dimensional (3D) MRA or as a time resolved 3D (4D) MRA without physiologic synchronization, in which case cardiac and respiratory motion may blur the edges of the vessels and cardiac chambers. Ferumoxytol has recently been a popular contrast agent for MRA in patients with chronic renal failure. Noncontrast 3D MRA with ECG gating and respiratory navigation are safe and accurate noninvasive cross-sectional imaging techniques for the visualization of great vessels of the heart and coronary arteries in a variety of cardiovascular disorders including complex congenital heart diseases. Noncontrast flow dependent MRA techniques such as time of flight, phase contrast, and black-blood MRA techniques can be used as complementary or primary techniques. Here we review both conventional and relatively new contrast enhanced and non-contrast enhanced MRA techniques including ferumoxytol enhanced MRA, and bright-blood and water-fat separation based noncontrast 3D MRA techniques.
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Affiliation(s)
- Murat Kocaoglu
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Amol Pednekar
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Robert J Fleck
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, MLC1 5031, 3333 Burnet Ave, Cincinnati, OH 45229, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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2
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Vuissoz PA. Editorial for "Simultaneous Highly Efficient Contrast-Free Lumen and Vessel Wall MR Imaging for Anatomical Assessment of Aortic Disease". J Magn Reson Imaging 2023; 58:1123-1124. [PMID: 36780125 DOI: 10.1002/jmri.28612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 02/14/2023] Open
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3
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Henningsson M, Malik S, Botnar R, Castellanos D, Hussain T, Leiner T. Black-Blood Contrast in Cardiovascular MRI. J Magn Reson Imaging 2020; 55:61-80. [PMID: 33078512 PMCID: PMC9292502 DOI: 10.1002/jmri.27399] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/14/2022] Open
Abstract
MRI is a versatile technique that offers many different options for tissue contrast, including suppressing the blood signal, so‐called black‐blood contrast. This contrast mechanism is extremely useful to visualize the vessel wall with high conspicuity or for characterization of tissue adjacent to the blood pool. In this review we cover the physics of black‐blood contrast and different techniques to achieve blood suppression, from methods intrinsic to the imaging readout to magnetization preparation pulses that can be combined with arbitrary readouts, including flow‐dependent and flow‐independent techniques. We emphasize the technical challenges of black‐blood contrast that can depend on flow and motion conditions, additional contrast weighting mechanisms (T1, T2, etc.), magnetic properties of the tissue, and spatial coverage. Finally, we describe specific implementations of black‐blood contrast for different vascular beds.
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Affiliation(s)
- Markus Henningsson
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shaihan Malik
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rene Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Castellanos
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tarique Hussain
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Division of Pediatric Radiology, Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tim Leiner
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
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4
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Tan EJ, Zhang S, Tirukonda P, Chong LR. REACT - A novel flow-independent non-gated non-contrast MR angiography technique using magnetization-prepared 3D non-balanced dual-echo dixon method: Preliminary clinical experience. Eur J Radiol Open 2020; 7:100238. [PMID: 32548214 PMCID: PMC7286964 DOI: 10.1016/j.ejro.2020.100238] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/29/2022] Open
Abstract
Flow-independent relaxation-based non-contrast MR angiography techniques yield good signal-to-noise ratio and high blood-tissue contrast, complementing non-contrast flow-dependent and contrast-enhanced MR angiography techniques in the assessment of vascular disorders. However, these techniques often suffer from imaging artifacts at high magnetic field strengths or across large fields-of-view. Relaxation-Enhanced Angiography without Contrast and Triggering (REACT) is a recently introduced flow-independent non-gated non-contrast three-dimensional MR angiography technique that has been developed to mitigate some of these issues. We present our initial experience with the clinical applications of REACT in imaging disorders of the central and peripheral vascular systems.
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Affiliation(s)
- Eu Jin Tan
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Shuo Zhang
- Philips Healthcare Singapore, 622 Lorong 1 Toa Payoh, Philips APAC Center Level 1, 319763, Singapore.,Philips DACH GmbH, Röntgenstraße 24-26, 22335, Hamburg, Germany
| | - Prasanna Tirukonda
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
| | - Le Roy Chong
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, 529889, Singapore
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5
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Hajhosseiny R, Bahaei TS, Prieto C, Botnar RM. Molecular and Nonmolecular Magnetic Resonance Coronary and Carotid Imaging. Arterioscler Thromb Vasc Biol 2020; 39:569-582. [PMID: 30760017 DOI: 10.1161/atvbaha.118.311754] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Atherosclerosis is the leading cause of cardiovascular morbidity and mortality. Over the past 2 decades, increasing research attention is converging on the early detection and monitoring of atherosclerotic plaque. Among several invasive and noninvasive imaging modalities, magnetic resonance imaging (MRI) is emerging as a promising option. Advantages include its versatility, excellent soft tissue contrast for plaque characterization and lack of ionizing radiation. In this review, we will explore the recent advances in multicontrast and multiparametric imaging sequences that are bringing the aspiration of simultaneous arterial lumen, vessel wall, and plaque characterization closer to clinical feasibility. We also discuss the latest advances in molecular magnetic resonance and multimodal atherosclerosis imaging.
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Affiliation(s)
- Reza Hajhosseiny
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,National Heart and Lung Institute, Imperial College London, United Kingdom (R.H.)
| | - Tamanna S Bahaei
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.)
| | - Claudia Prieto
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile (C.P., R.M.B.)
| | - René M Botnar
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom (R.H., T.S.B., C.P., R.M.B.).,Escuela de Ingeniería, Pontificia Universidad Catolica de Chile, Santiago, Chile (C.P., R.M.B.)
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6
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Yoneyama M, Zhang S, Hu HH, Chong LR, Bardo D, Miller JH, Toyonari N, Katahira K, Katsumata Y, Pokorney A, Ng CK, Kouwenhoven M, Van Cauteren M. Free-breathing non-contrast-enhanced flow-independent MR angiography using magnetization-prepared 3D non-balanced dual-echo Dixon method: A feasibility study at 3 Tesla. Magn Reson Imaging 2019; 63:137-146. [DOI: 10.1016/j.mri.2019.08.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/18/2019] [Accepted: 08/15/2019] [Indexed: 11/30/2022]
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7
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Milotta G, Ginami G, Cruz G, Neji R, Prieto C, Botnar RM. Simultaneous 3D whole-heart bright-blood and black blood imaging for cardiovascular anatomy and wall assessment with interleaved T 2 prep-IR. Magn Reson Med 2019; 82:312-325. [PMID: 30896049 DOI: 10.1002/mrm.27734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To develop a motion-corrected 3D flow-insensitive imaging approach interleaved T2 prepared-inversion recovery (iT2 prep-IR) for simultaneous lumen and wall visualization of the great thoracic vessels and cardiac structures. METHODS A 3D flow-insensitive approach for simultaneous cardiovascular lumen and wall visualization (iT2 prep) has been previously proposed. This approach requires subject-dependent weighted subtraction to completely null the arterial blood signal in the black-blood volume. Here, we propose an (T2 prep-IR) approach to improve wall visualization and remove need for weighted subtraction. The proposed sequence is based on the acquisition and direct subtraction of 2 interleaved 3D whole-heart data sets acquired with and without T2 prep-IR preparation. Image navigators are acquired before data acquisition to enable 2D translational and 3D non-rigid motion correction allowing 100% respiratory scan efficiency. The proposed approach was evaluated in 10 healthy subjects and compared with the conventional 2D double inversion recovery (DIR) sequence and the 3D iT2 prep sequence. Additionally, 5 patients with congenital heart disease were acquired to test the clinical feasibility of the proposed approach. RESULTS The proposed iT2 prep-IR sequence showed improved blood nulling compared to both DIR and iT2 prep techniques in terms of SNR (SNRblood = 6.9, 12.2, and 18.2, respectively) and contrast-to-noise-ratio (CNRmyoc-blood = 28.4, 15.4, and 15.3, respectively). No statistical difference was observed between iT2 prep-IR, iT2 prep and DIR atrial and ventricular wall thickness quantification. CONCLUSION The proposed interleaved T2 prep-IR sequence enables the simultaneous lumen and wall visualization of cardiac structures and shows promising results in terms of SNR, CNR, and wall thickness measurement.
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Affiliation(s)
- Giorgia Milotta
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Giulia Ginami
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Gastao Cruz
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - René M Botnar
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile
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8
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Henningsson M, Zahr RA, Dyer A, Greil GF, Burkhardt B, Tandon A, Hussain T. Feasibility of 3D black-blood variable refocusing angle fast spin echo cardiovascular magnetic resonance for visualization of the whole heart and great vessels in congenital heart disease. J Cardiovasc Magn Reson 2018; 20:76. [PMID: 30474554 PMCID: PMC6260764 DOI: 10.1186/s12968-018-0508-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 11/14/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Volumetric black-blood cardiovascular magnetic resonance (CMR) has been hampered by long scan times and flow sensitivity. The purpose of this study was to assess the feasibility of black-blood, electrocardiogram (ECG)-triggered and respiratory-navigated 3D fast spin echo (3D FSE) for the visualization of the whole heart and great vessels. METHODS The implemented 3D FSE technique used slice-selective excitation and non-selective refocusing pulses with variable flip angles to achieve constant echo signal for tissue with T1 (880 ms) and T2 (40 ms) similar to the vessel wall. Ten healthy subjects and 21 patients with congenital heart disease (CHD) underwent 3D FSE and conventional 3D balanced steady-state free precession (bSSFP). The sequences were compared in terms of ability to perform segmental assessment, local signal-to-noise ratio (SNRl) and local contrast-to-noise ratio (CNRl). RESULTS In both healthy subjects and patients with CHD, 3D FSE showed superior pulmonary vein but inferior coronary artery origin visualisation compared to 3D bSFFP. However, in patients with CHD the combination of 3D bSSFP and 3D FSE whole-heart imaging improves the success rate of cardiac morphological diagnosis to 100% compared to either technique in isolation (3D FSE, 23.8% success rate, 3D bSSFP, 5% success rate). In the healthy subjects SNRl for 3D bSSFP was greater than for 3D FSE (30.1 ± 7.3 vs 20.9 ± 5.3; P = 0.002) whereas the CNRl was comparable (17.3 ± 5.6 vs 17.4 ± 4.9; P = 0.91) between the two scans. CONCLUSIONS The feasibility of 3D FSE for whole-heart black-blood CMR imaging has been demonstrated. Due to their high success rate for segmental assessment, the combination of 3D bSSFP and 3D FSE may be an attractive alternative to gadolinium contrast enhanced morphological CMR in patients with CHD.
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Affiliation(s)
- Markus Henningsson
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Riad Abou Zahr
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Adrian Dyer
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Gerald F. Greil
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Barbara Burkhardt
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Animesh Tandon
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
| | - Tarique Hussain
- Departments of Pediatrics and Radiology, University of Texas Southwestern/Children’s Health, Dallas, TX USA
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9
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Lee SE, Nguyen C, Xie Y, Deng Z, Zhou Z, Li D, Chang HJ. Recent Advances in Cardiac Magnetic Resonance Imaging. Korean Circ J 2018; 49:146-159. [PMID: 30468040 PMCID: PMC6351278 DOI: 10.4070/kcj.2018.0246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/25/2018] [Accepted: 10/23/2018] [Indexed: 01/10/2023] Open
Abstract
Cardiac magnetic resonance (CMR) imaging provides accurate anatomic information and advanced soft contrast, making it the reference standard for assessing cardiac volumes and systolic function. In this review, we summarize the recent advances in CMR sequences. New technical development has widened the use of CMR imaging beyond the simple characterization of myocardial scars and assessment of contractility. These novel CMR sequences offer comprehensive assessments of coronary plaque characterization, myocardial fiber orientation, and even metabolic activity, and they can be readily applied in clinical settings. CMR imaging is able to provide new insights into understanding the pathophysiologic process of underlying cardiac disease, and it can help physicians choose the best treatment strategies. Although several limitations, including the high cost and time-consuming process, have limited the widespread clinical use of CMR imaging so far, recent advances in software and hardware technologies have made the future more promising.
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Affiliation(s)
- Sang Eun Lee
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.,Integrative Cardiovascular Imaging Center, Yonsei University Health System, Seoul, Korea.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Christopher Nguyen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Zixin Deng
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Zhengwei Zhou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hyuk Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.,Integrative Cardiovascular Imaging Center, Yonsei University Health System, Seoul, Korea.
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10
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A mosaic structure multi-level vascular network design for skull tissue engineering. Comput Biol Med 2018; 104:70-80. [PMID: 30445296 DOI: 10.1016/j.compbiomed.2018.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/28/2018] [Accepted: 10/28/2018] [Indexed: 10/28/2022]
Abstract
In human skull tissue engineering scaffolds, cell growth and osteogenesis are limited due to the lack of vascular structure. Therefore, a mosaic structure vascular parameterized design method is proposed according to the scanning characteristics of the diploic vein. Using micro-CT scans of skull samples, the features of the diploic vein were extracted, and a multi-level vascular network model was established based on a power diagram. Considering the characteristics of blood flow in the veins, finite element analysis (FEA) of the fluid-solid coupling was established to analyze the effect of blood on vessels with four-level mosaic structures. The results showed that the deformation and stress distribution of vessels were reasonable, and the blood pressure, velocity and shear stress in the designed vascular structure could meet the cell growth requirements. The mosaic structure was prepared by PDMS and cultured in vitro using HUVECs. It was found that most of the cells survived after 48 h, and some cells were attached to the surface mosaic structure. In this method, different levels of vessels nest together, with a curvature that matches the shape of the skull, forming a similar morphology to the native diploic vein, and the local structures can be adjusted flexibly. This mosaic structure vascular design method can be used for network vascular design and experimental studies in hard tissues.
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11
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Abstract
PURPOSE OF REVIEW This short review summarizes the recent development in clinical and experimental imaging techniques for coronary atherosclerosis. RECENT FINDINGS Coronary atherosclerosis is the underlying disease of myocardial infarction, the leading cause of death in the industrialized world. Conventional ways of risk assessment, including evaluation of traditional risk factors and interrogation of luminal stenosis, have proven imprecise for the prediction of major events. Rapid advances in noninvasive imaging techniques including MRI, CT, and PET, as well as catheter-based methods, have opened the doors to more in-depth interrogation of plaque burden, composition, and many crucial pathological processes such as inflammation and hemorrhage. These emerging imaging modalities and methodologies, combined with conventional imaging evidences of anatomy and ischemia, offer the promises to provide comprehensive information of the disease status. There is tremendous clinical potential for imaging to improve the current management of coronary atherosclerosis, including the identification of high-risk patients for aggressive therapies and guiding personalized treatment. In this review, we provide an overview of the state-of-the-art coronary plaque imaging techniques focusing on their respective strengths and weaknesses, as well as their clinical outlook.
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Affiliation(s)
- Yibin Xie
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA
| | - Hang Jin
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, China
| | - Mengsu Zeng
- Department of Radiology, Zhongshan Hospital, Fudan University, 180 Feng Lin Road, Shanghai, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 400, Los Angeles, CA, 90048, USA.
- Department of Bioengineering, University of California, Los Angeles, CA, USA.
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12
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Jansen CHP, Perera D, Wiethoff AJ, Phinikaridou A, Razavi RM, Rinaldi A, Marber MS, Greil GF, Nagel E, Maintz D, Redwood S, Botnar RM, Makowski MR. Contrast-enhanced magnetic resonance imaging for the detection of ruptured coronary plaques in patients with acute myocardial infarction. PLoS One 2017; 12:e0188292. [PMID: 29190694 PMCID: PMC5708680 DOI: 10.1371/journal.pone.0188292] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022] Open
Abstract
Purpose X-ray coronary angiography (XCA) is the current gold standard for the assessment of lumen encroaching coronary stenosis but XCA does not allow for early detection of rupture-prone vulnerable plaques, which are thought to be the precursor lesions of most acute myocardial infarctions (AMI) and sudden death. The aim of this study was to investigate the potential of delayed contrast-enhanced magnetic resonance coronary vessel wall imaging (CE-MRCVI) for the detection of culprit lesions in the coronary arteries. Methods 16 patients (13 male, age 61.9±8.6 years) presenting with sub-acute MI underwent CE-MRCVI within 24-72h prior to invasive XCA. CE-MRCVI was performed using a T1-weighted 3D gradient echo inversion recovery sequence (3D IR TFE) 40±4 minutes following the administration of 0.2 mmol/kg gadolinium-diethylenetriamine-pentaacetic acid (DTPA) on a 3T MRI scanner equipped with a 32-channel cardiac coil. Results 14 patients were found to have culprit lesions (7x LAD, 1xLCX, 6xRCA) as identified by XCA. Quantitative CE-MRCVI correctly identified the culprit lesion location with a sensitivity of 79% and excluded culprit lesion formation with a specificity of 99%. The contrast to noise ratio (CNR) of culprit lesions (9.7±4.1) significantly exceeded CNR values of segments without culprit lesions (2.9±1.9, p<0.001). Conclusion CE-MRCVI allows the selective visualization of culprit lesions in patients immediately after myocardial infarction (MI). The pronounced contrast uptake in ruptured plaques may represent a surrogate biomarker of plaque activity and/or vulnerability.
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Affiliation(s)
- Christian H. P. Jansen
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- * E-mail:
| | - Divaka Perera
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Andrea J. Wiethoff
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- Philips Healthcare, Guildford, United Kingdom
| | - Alkystis Phinikaridou
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Reza M. Razavi
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - Aldo Rinaldi
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Mike S. Marber
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Gerald F. Greil
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Eike Nagel
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
| | - David Maintz
- Department of Radiology, University Muenster, Muenster, Germany
| | - Simon Redwood
- Cardiovascular Centre, Guy’s and St. Thomas’ Hospital, London, United Kingdom
| | - Rene M. Botnar
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Wellcome Trust and EPSRC Medical Engineering Center, London, United Kingdom
- Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Marcus R. Makowski
- King’s College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
- BHF Centre of Excellence, London, United Kingdom
- NIHR Biomedical Research Centre and King’s College London, London, United Kingdom
- Department of Radiology, Charité, Berlin, Germany
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13
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Update on the Role of Cardiac Magnetic Resonance Imaging in Congenital Heart Disease. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017; 19:2. [PMID: 28144782 DOI: 10.1007/s11936-017-0504-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OPINION STATEMENT Cardiac magnetic resonance imaging (CMR) is an important imaging modality in the evaluation of congenital heart diseases (CHD). CMR has several strengths including good spatial and temporal resolutions, wide field-of-view, and multi-planar imaging capabilities. CMR provides significant advantages for imaging in CHD through its ability to measure function, flow and vessel sizes, create three-dimensional reconstructions, and perform tissue characterization, all in a single imaging study. Thus, CMR is the most comprehensive imaging modality available today for the evaluation of CHD. Newer MRI sequences and post-processing tools will allow further development of quantitative methods of analysis, and opens the door for risk stratification in CHD. CMR also can interface with computer modeling, 3D printing, and other methods of understanding the complex anatomic and physiologic relationships in CHD.
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14
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Abstract
Non-invasive external magnetic resonance imaging (MRI) of large vessel atherosclerosis is a robust and promising imaging modality that can be applied for the evaluation of the atherosclerotic process in large vessels. However, it requires expertise for setup and time for data acquisition and analysis. Intravascular MRI is a promising tool, but its use remains at the pre-clinical stage within selected research groups. In this review, the current status and future role of intravascular MRI for atherosclerotic plaque characterization are summarized, along with important challenges which will be necessary to overcome prior to the wide adoption of this technique.
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Affiliation(s)
- João L Cavalcante
- Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric Larose
- Faculté de médecine, Université Laval, Quebec, Quebec, Canada.
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval, 2725 chemin Sainte-Foy, Quebec, Quebec, G1V 4G5, Canada.
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15
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Cruz G, Atkinson D, Henningsson M, Botnar RM, Prieto C. Highly efficient nonrigid motion-corrected 3D whole-heart coronary vessel wall imaging. Magn Reson Med 2016; 77:1894-1908. [PMID: 27221073 PMCID: PMC5412916 DOI: 10.1002/mrm.26274] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 12/25/2022]
Abstract
Purpose To develop a respiratory motion correction framework to accelerate free‐breathing three‐dimensional (3D) whole‐heart coronary lumen and coronary vessel wall MRI. Methods We developed a 3D flow‐independent approach for vessel wall imaging based on the subtraction of data with and without T2‐preparation prepulses acquired interleaved with image navigators. The proposed method corrects both datasets to the same respiratory position using beat‐to‐beat translation and bin‐to‐bin nonrigid corrections, producing coregistered, motion‐corrected coronary lumen and coronary vessel wall images. The proposed method was studied in 10 healthy subjects and was compared with beat‐to‐beat translational correction (TC) and no motion correction for the left and right coronary arteries. Additionally, the coronary lumen images were compared with a 6‐mm diaphragmatic navigator gated and tracked scan. Results No significant differences (P > 0.01) were found between the proposed method and the gated and tracked scan for coronary lumen, despite an average improvement in scan efficiency to 96% from 59%. Significant differences (P < 0.01) were found in right coronary artery vessel wall thickness, right coronary artery vessel wall sharpness, and vessel wall visual score between the proposed method and TC. Conclusion The feasibility of a highly efficient motion correction framework for simultaneous whole‐heart coronary lumen and vessel wall has been demonstrated. Magn Reson Med 77:1894–1908, 2017. © 2016 International Society for Magnetic Resonance in Medicine
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Affiliation(s)
- Gastão Cruz
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - David Atkinson
- Centre for Medical Imaging, University College London, London, United Kingdom
| | - Markus Henningsson
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom
| | - Rene M Botnar
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
| | - Claudia Prieto
- King's College London, Division of Imaging Sciences and Biomedical Engineering, London, United Kingdom.,Pontificia Universidad Católica de Chile, Escuela de Ingeniería, Santiago, Chile
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16
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Dweck MR, Puntmann VO, Vesey AT, Fayad ZA, Nagel E. MR Imaging of Coronary Arteries and Plaques. JACC Cardiovasc Imaging 2016; 9:306-16. [DOI: 10.1016/j.jcmg.2015.12.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/25/2015] [Accepted: 12/03/2015] [Indexed: 01/13/2023]
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17
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Xie G, Bi X, Liu J, Yang Q, Natsuaki Y, Conte AH, Liu X, Li K, Li D, Fan Z. Three-dimensional coronary dark-blood interleaved with gray-blood (cDIG) magnetic resonance imaging at 3 tesla. Magn Reson Med 2015; 75:997-1007. [PMID: 25858528 DOI: 10.1002/mrm.25585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/20/2014] [Accepted: 11/25/2014] [Indexed: 01/26/2023]
Abstract
PURPOSE Three-dimensional (3D) dark-blood MRI has shown great potential in coronary artery plaque evaluation. However, substantial variability in quantification could result from superficial calcification because of its low signal. To address this issue, a 3D coronary dark-blood interleaved with gray-blood (cDIG) technique was developed. METHODS cDIG is based on a balanced steady-state free precession readout combined with a local re-inversion-based double-inversion-recovery (LocReInv-DIR) preparation. The LocReInv-DIR is applied every two RR intervals. Dark-blood and gray-blood contrasts are collected in the first and second RR interval, respectively. To improve the respiratory gating efficiency, two independent navigators were developed to separately gate the respiratory motion for the two interleaved acquisitions. In vivo experiments in eight healthy subjects and one patient were conducted to validate the technique. RESULTS cDIG provided dual-contrasts without compromise in scan time. The dark-blood images with cDIG demonstrated excellent wall and lumen signal performances and morphological measurements. Advantageously, cDIG yielded a second contrast that was shown to help identify the superficial calcification in the coronary plaque of a patient. CONCLUSION A novel technique was developed for obtaining 3D coronary vessel wall and gray lumen images. The additional contrast may aid in identifying calcified nodules and thus potentially improve the evaluation of coronary plaque burden.
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Affiliation(s)
- Guoxi Xie
- Shenzhen Key Lab for MRI, BCMIIS, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, China.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Xiaoming Bi
- Siemens Healthcare, Los Angeles, California, USA
| | - Jiabin Liu
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qi Yang
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | | | | | - Xin Liu
- Shenzhen Key Lab for MRI, BCMIIS, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, China
| | - Kuncheng Li
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
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18
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Lavin B, Phinikaridou A, Henningsson M, Botnar RM. Current Development of Molecular Coronary Plaque Imaging using Magnetic Resonance Imaging towards Clinical Application. CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9309-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Keegan J. Coronary artery wall imaging. J Magn Reson Imaging 2014; 41:1190-202. [PMID: 25303707 DOI: 10.1002/jmri.24766] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 08/06/2014] [Accepted: 08/06/2014] [Indexed: 12/12/2022] Open
Abstract
Like X-Ray contrast angiography, MR coronary angiograms show the vessel lumens rather than the vessels themselves. Consequently, outward remodeling of the vessel wall, which occurs in subclinical coronary disease before luminal narrowing, cannot be seen. The current gold standard for assessing the coronary vessel wall is intravascular ultrasound, and more recently, optical coherence tomography, both of which are invasive and use ionizing radiation. A noninvasive, low-risk technique for assessing the vessel wall would be beneficial to cardiologists interested in the early detection of preclinical disease and for the safe monitoring of the progression or regression of disease in longitudinal studies. In this review article, the current state of the art in MR coronary vessel wall imaging is discussed, together with validation studies and recent developments.
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Affiliation(s)
- Jennifer Keegan
- Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London
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20
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Ding H, Fernandez-de-Manuel L, Schär M, Schuleri KH, Halperin H, He L, Zviman MM, Beinart R, Herzka DA. Three-dimensional whole-heart T2 mapping at 3T. Magn Reson Med 2014; 74:803-16. [PMID: 25242141 DOI: 10.1002/mrm.25458] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/23/2014] [Accepted: 08/25/2014] [Indexed: 01/28/2023]
Abstract
PURPOSE Detecting variations in myocardial water content with T2 mapping is superior to conventional T2 -weighted MRI since quantification enables direct observation of complicated pathology. Most commonly used T2 mapping techniques are limited in achievable spatial and/or temporal resolution, both of which reduce accuracy due to partial-volume averaging and misregistration between images. The goal of this study was to validate a novel free breathing T2 mapping sequence that overcomes these limitations. METHODS The proposed technique was made insensitive to heart rate variability through the use of a saturation prepulse to reset magnetization every heartbeat. Respiratory navigator-gated, differentially T2 -weighted volumes were interleaved per heartbeat, guaranteeing registered images and robust voxel-by-voxel T2 maps. Free breathing acquisitions removed limits on spatial resolution and allowed short diastolic windows. Accuracy was quantified with simulations and phantoms. RESULTS Homogeneous three-dimensional (3D) T2 maps were obtained from normal human subjects and swine. Normal human and swine left ventricular T2 values were 42.3 ± 4.0 and 43.5 ± 4.3 ms, respectively. The T2 value for edematous myocardium obtained from a swine model of acute myocardial infarction was 59.1 ± 7.1 ms. CONCLUSION Free-breathing accurate 3D T2 mapping is feasible and may be applicable in myocardial assessment in lieu of current clinical black blood, T2 -weighted techniques.
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Affiliation(s)
- Haiyan Ding
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, People's Republic of China.,Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Laura Fernandez-de-Manuel
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Biomedical Image Technologies Laboratory, ETSI Telecomunicación, Universidad Politécnica de Madrid, and CIBER-BBN, Madrid, Spain
| | - Michael Schär
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Philips Healthcare, Cleveland, Ohio, USA
| | - Karl H Schuleri
- Department of Medicine, Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Henry Halperin
- Department of Medicine, Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Tsinghua University, Beijing, People's Republic of China
| | - M Muz Zviman
- Department of Medicine, Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Roy Beinart
- Department of Medicine, Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.,Heart Institute, Sheba Medical Center, Tel Aviv University, Ramat Gan, Israel
| | - Daniel A Herzka
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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21
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Hussain T, Henningsson M, Butzbach B, Lossnitzer D, Greil GF, Andia ME, Botnar RM. Combined coronary lumen and vessel wall magnetic resonance imaging with i-T2prep: influence of nitroglycerin. Int J Cardiovasc Imaging 2014; 31:77-82. [PMID: 25200588 DOI: 10.1007/s10554-014-0525-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 08/23/2014] [Indexed: 10/24/2022]
Abstract
It has been shown that sublingual nitroglycerin (NTG) improves image quality of coronary lumen magnetic resonance angiography. Our aim was to investigate the influence of NTG on coronary lumen and vessel wall image quality using a combined, single sequence approach (i-T2prep), which is able to image both within the known time frame of action of NTG. Ten healthy volunteers underwent right coronary artery lumen and vessel wall imaging using the i-T2prep sequence before and after administration of NTG. Image quality was assessed qualitatively and quantitatively. Diameter, length and wall thickness were also measured using dedicated semi-automatic software. NTG induced coronary vasodilatation (lumen diameter increased from 2.16 ± 0.32 to 2.52 ± 0.59 mm; p = 0.036). As a result, visualized lumen length (9.8 ± 2.6 to 11.4 ± 3.3 cm; p = 0.025) and qualitative lumen image quality (median 3 (interquartile range 2-3.25) vs. median 3 (interquartile range 3-4); p = 0.046) both improved. Vessel wall imaging also demonstrated a significant improvement in vessel wall sharpness after NTG (24.8 vs. 27.3 %; p = 0.036). This study demonstrates the benefits of NTG for coronary lumen and vessel wall imaging using a combined sequence, i-T2prep. The methodology described here has great potential for future pathophysiological studies.
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Affiliation(s)
- Tarique Hussain
- Division of Imaging Sciences and Biomedical Engineering, King's College London, St Thomas' Hospital, 4th Floor Lambeth Wing, Westminster Bridge Road, London, SE17EH, UK,
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22
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Kuo YS, Kelle S, Lee C, Hinojar R, Nagel E, Botnar R, Puntmann VO. Contrast-enhanced cardiovascular magnetic resonance imaging of coronary vessel wall: state of art. Expert Rev Cardiovasc Ther 2014; 12:255-63. [PMID: 24417398 DOI: 10.1586/14779072.2014.877838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Coronary wall imaging by cardiovascular magnetic resonance (CMR) emerges as a promising method to detect vascular injury and remodeling directly within the coronary vascular wall. In this review, the current evidence on coronary wall enhancement using CMR is presented and summarized, with particular focus on its ability to detect inflammation in atherosclerosis, Takayasu's arteritis, acute coronary syndromes and immune-mediated inflammatory vasculitides. The authors review the possible mechanisms of coronary wall contrast enhancement on CMR and discuss the technical considerations and limitations. Lastly, the potential clinical applications and possibilities for future research are proposed.
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Affiliation(s)
- Yen-Shu Kuo
- Department of Cardiovascular Imaging, The Rayne Institute, King's College London, London, UK
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23
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Makowski MR, Henningsson M, Spuentrup E, Kim WY, Maintz D, Manning WJ, Botnar RM. Characterization of coronary atherosclerosis by magnetic resonance imaging. Circulation 2013; 128:1244-55. [PMID: 24019445 DOI: 10.1161/circulationaha.113.002681] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marcus R Makowski
- Division of Imaging Sciences and Biomedical Engineering (M.R.M., M.H., R.M.B.), BHF Center of Research Excellence (M.R.M., M.H., R.M.B.), Wellcome Trust and EPSRC Medical Engineering Center (M.H., R.M.B.), and NIHR Biomedical Research Center (M.H., R.M.B.), King's College London, London, UK; Department of Radiology, Charité, Berlin, Germany (M.R.M.); Department of Radiology and Nuclear Medicine, Hospital Saarbrucken, Saarbrucken, Germany (E.S.); Department of Cardiology, Aarhus University Hospital, Skejby Sygehus, Denmark (W.Y.K.); Department of Radiology, University of Cologne, Cologne, Germany (D.M.); and Department of Medicine, Cardiovascular Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (W.J.M.)
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