Skip to main content
Log in

MRI in coronary artery disease

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Diagnosis of coronary artery disease (CAD) is a major challenge for medical imaging, because CAD is the leading cause of death in developed nations. Several non-invasive tests are used in clinical routine for the detection of CAD. However, due to limited sensitivity and specificity, the reliable diagnosis as well as the exclusion of CAD can only be established by catheter angiography. In patients with known CAD, therapeutic decisions require accurate information on myocardial function, ischemia and viability. Recently, magnetic resonance (MR) imaging has emerged as a non-invasive cardiac imaging technique that provides information on cardiac morphology, cardiac function, myocardial viablitiy, and coronary morphology. This review discusses technical aspects and the clinical impact of different MR techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. American AH (2002) 2003 Heart and stroke statistical update. American Heart Association, Dallas

    Google Scholar 

  2. Barkhausen J, Ruehm SG, Goyen M, Buck T, Laub G, Debatin JF (2001) MR evaluation of ventricular function: true fast imaging with steady-state precession versus fast low-angle shot cine MR imaging: feasibility study. Radiology 219:264–269

    CAS  PubMed  Google Scholar 

  3. Barkhausen J, Ebert W, Debatin JF, Weinmann HJ (2002) Imaging of myocardial infarction: comparison of magnevist and gadophrin-3 in rabbits. J Am Coll Cardiol 39:1392–1398

    Article  CAS  PubMed  Google Scholar 

  4. Barkhausen J, Hunold P, Eggebrecht H, Schuler WO, Sabin GV, Erbel R, Debatin JF (2002) Detection and characterization of intracardiac thrombi on MR imaging. Am J Roentgenol 179:1539–1544

    Google Scholar 

  5. Barkhausen J, Hunold P, Jochims M, Eggebrecht H, Sabin GV, Erbel R, Debatin JF (2002) Comparison of gradient-echo and steady state free precession sequences for 3D-navigator MR angiography of coronary arteries. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174:725–730

    Article  CAS  PubMed  Google Scholar 

  6. Barkhausen J, Ebert W, Heyer C, Debatin JF, Weinmann HJ (2003) Detection of atherosclerotic plaque with gadofluorine-enhanced magnetic resonance imaging. Circulation 108:605–609

    Article  CAS  PubMed  Google Scholar 

  7. Beek AM, Kuhl HP, Bondarenko O, Twisk JW, Hofman MB, van Dockum WG, Visser CA, van Rossum AC (2003) Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol 42:895–901

    Article  PubMed  Google Scholar 

  8. Bertschinger KM, Nanz D, Buechi M, Luescher TF, Marincek B, von Schulthess GK, Schwitter J (2001) Magnetic resonance myocardial first-pass perfusion imaging: parameter optimization for signal response and cardiac coverage. J Magn Reson Imaging 14:556–562

    Article  CAS  PubMed  Google Scholar 

  9. Brittain JH, Hu BS, Wright GA, Meyer CH, Macovski A, Nishimura DG (1995) Coronary angiography with magnetization-prepared T2 contrast. Magn Reson Med 33:689–696

    CAS  PubMed  Google Scholar 

  10. Bruckenberger E (2001) Herzbericht 2000 mit Transplantationschirurgie. 13. Bericht des Krankenhausausschusses der Arbeitsgemeinschaft der obersten Landesgesundheitsbehörden der Länder (AOLG). Hannover

  11. van Dantzig JM, Delemarre BJ, Bot H, Visser CA (1996) Left ventricular thrombus in acute myocardial infarction. Eur Heart J 17:1640–1645

    PubMed  Google Scholar 

  12. Debatin JF, Nadel SN, Paolini JF, Sostman HD, Coleman RE, Evans AJ, Beam C, Spritzer CE, Bashore TM (1992) Cardiac ejection fraction: phantom study comparing cine MR imaging, radionuclide blood pool imaging, and ventriculography. J Magn Reson Imaging 2:135–142

    CAS  PubMed  Google Scholar 

  13. Dirksen MS, Lamb HJ, van der Geest R, de Roos A (2003) Toward comparability of coronary magnetic resonance angiography: proposal for a standardized quantitative assessment. Eur Radiol 13:2353–2357

    Article  PubMed  Google Scholar 

  14. Falk E, Shah PK, Fuster V (1995) Coronary plaque disruption. Circulation 92:657–671

    CAS  PubMed  Google Scholar 

  15. Fayad ZA, Fuster V (2001) Clinical imaging of the high-risk or vulnerable atherosclerotic plaque. Circ Res 89:305–316

    CAS  PubMed  Google Scholar 

  16. Flacke S, Fischer S, Scott MJ, Fuhrhop RJ, Allen JS, McLean M, Winter P, Sicard GA, Gaffney PJ, Wickline SA, Lanza GM (2001) Novel mri contrast agent for molecular imaging of fibrin: implications for detecting vulnerable plaques. Circulation 104:1280–1285

    CAS  PubMed  Google Scholar 

  17. Gersh BJ, Anderson JL (1993) Thrombolysis and myocardial salvage. Results of clinical trials and the animal paradigm—paradoxic or predictable? Circulation 88:296–306

    CAS  PubMed  Google Scholar 

  18. Gersh BJ, Kronmal RA, Frye RL, Schaff HV, Ryan TJ, Gosselin AJ, Kaiser GC, Killip T III (1983) Coronary arteriography and coronary artery bypass surgery: morbidity and mortality in patients ages 65 years or older. A report from the coronary artery surgery study. Circulation 67:483–491

    CAS  PubMed  Google Scholar 

  19. Herborn CU, Barkhausen J, Paetsch I, Hunold P, Mahler M, Shamsi K, Nagel E (2003) Coronary arteries: contrast-enhanced MR imaging with SH L 643A—experience in 12 volunteers. Radiology 229:217–223

    PubMed  Google Scholar 

  20. Hundley WG, Morgan TM, Neagle CM, Hamilton CA, Rerkpattanapipat P, Link KM (2002) Magnetic resonance imaging determination of cardiac prognosis. Circulation 106:2328–2333

    Article  PubMed  Google Scholar 

  21. Hunold P, Brandt-Mainz K, Freudenberg L, Vogt FM, Neumann T, Knipp S, Barkhausen J (2002) Evaluation of myocardial viability with contrast-enhanced magnetic resonance imaging—comparison of the late enhancement technique with positronemission tomography. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174:867–873

    Article  CAS  PubMed  Google Scholar 

  22. Karnegis JN, Heinz J (1979) The risk of diagnostic cardiovascular catheterization. Am Heart J 97:291–297

    Article  CAS  PubMed  Google Scholar 

  23. Kim RJ, Fieno DS, Parrish TB, Harris K, Chen EL, Simonetti O, Bundy J, Finn JP, Klocke FJ, Judd RM (1999) Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation 100:1992–2002

    CAS  PubMed  Google Scholar 

  24. Kim RJ, Wu E, Rafael A, Chen EL, Parker MA, Simonetti O, Klocke FJ, Bonow RO, Judd RM (2000) The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med 343:1445–1453

    Article  CAS  PubMed  Google Scholar 

  25. Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E, Langerak SE, Weber OM, Pedersen EM, Schmidt M, Botnar RM, Manning WJ (2001) Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med 345:1863–1869

    Article  CAS  PubMed  Google Scholar 

  26. Klein C, Nekolla SG, Bengel FM, Momose M, Sammer A, Haas F, Schnackenburg B, Delius W, Mudra H, Wolfram D, Schwaiger M (2002) Assessment of myocardial viability with contrast-enhanced magnetic resonance imaging: comparison with positron emission tomography. Circulation 105:162–167

    Article  PubMed  Google Scholar 

  27. Lee TH, Boucher CA (2001) Clinical practice. Noninvasive tests in patients with stable coronary artery disease. N Engl J Med 344:1840–1845

    Article  CAS  PubMed  Google Scholar 

  28. Lipton MJ, Bogaert J, Boxt LM, Reba RC (2002) Imaging of ischemic heart disease. Eur Radiol 12:1061–1080

    Article  PubMed  Google Scholar 

  29. Mohrs OK, Bachmann GF, Oesingmann N, Kalden P, Rominger MB, Kreitner KF, Thelen M (2001) Evaluation of left ventricular aneurysms before and after surgery using Cine-MRI. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173:798–804

    Article  CAS  PubMed  Google Scholar 

  30. Mollet NR, Dymarkowski S, Volders W, Wathiong J, Herbots L, Rademakers FE, Bogaert J (2002) Visualization of ventricular thrombi with contrast-enhanced magnetic resonance imaging in patients with ischemic heart disease. Circulation 106:2873–2876

    Article  PubMed  Google Scholar 

  31. Nagel E, Lehmkuhl HB, Bocksch W, Klein C, Vogel U, Frantz E, Ellmer A, Dreysse S, Fleck E (1999) Noninvasive diagnosis of ischemia-induced wall motion abnormalities with the use of high-dose dobutamine stress MRI: comparison with dobutamine stress echocardiography. Circulation 99:763–770

    CAS  PubMed  Google Scholar 

  32. Nagel E, al-Saadi N, Fleck E (2000) Cardiovascular magnetic resonance: myocardial perfusion. Herz 25:409–416

    Article  CAS  PubMed  Google Scholar 

  33. Nesto RW, Kowalchuk GJ (1987) The ischemic cascade: temporal sequence of hemodynamic, electrocardiographic and symptomatic expressions of ischemia. Am J Cardiol 59:23C–30C

    Article  CAS  PubMed  Google Scholar 

  34. Nissen SE, Yock P (2001) Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation 103:604–616

    CAS  PubMed  Google Scholar 

  35. Paydarfar D, Krieger D, Dib N, Blair RH, Pastore JO, Stetz JJ Jr, Symes JF (2001) In vivo magnetic resonance imaging and surgical histopathology of intracardiac masses: distinct features of subacute thrombi. Cardiology 95:40–47

    Article  CAS  PubMed  Google Scholar 

  36. Quick HH, Debatin JF, Ladd ME (2002) MR imaging of the vessel wall. Eur Radiol 12:889–900

    Article  PubMed  Google Scholar 

  37. Sandstede JJ (2003) Assessment of myocardial viability by MR imaging. Eur Radiol 13:52–61

    PubMed  Google Scholar 

  38. Sardanelli F, Zandrino F, Molinari G, Iozzelli A, Balbi M, Barsotti A (2002) MR evaluation of coronary stents with navigator echo and breath-hold cine gradient-echo techniques. Eur Radiol 12:193–200

    Article  CAS  PubMed  Google Scholar 

  39. Simonetti OP, Kim RJ, Fieno DS, Hillenbrand HB, Wu E, Bundy JM, Finn JP, Judd RM (2001) An improved MR imaging technique for the visualization of myocardial infarction. Radiology 218:215–223

    CAS  PubMed  Google Scholar 

  40. Slavin GS, Wolff SD, Gupta SN, Foo TK (2001) First-pass myocardial perfusion MR imaging with interleaved notched saturation: feasibility study. Radiology 219:258–263

    CAS  PubMed  Google Scholar 

  41. Sommer T, Hofer U, Hackenbroch M, Meyer C, Flacke S, Schmiedel A, Schmitz C, Thiemann K, Omran H, Schild H (2002) Submillimeter 3D coronary MR angiography with real-time navigator correction in 107 patients with suspected coronary artery disease. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174:459–466

    Article  CAS  PubMed  Google Scholar 

  42. Versteegh MI, Lamb HJ, Bax JJ, Curiel FB, van der Wall EE, de Roos A, Dion RA (2003) MRI evaluation of left ventricular function in anterior LV aneurysms before and after surgical resection. Eur J Cardiothorac Surg 23:609–613

    Article  PubMed  Google Scholar 

  43. Weber C, Steiner P, Sinkus R, Dill T, Bornert P, Adam G (2002) Correlation of 3D MR coronary angiography with selective coronary angiography: feasibility of the motion-adapted gating technique. Eur Radiol 12:718–726

    Article  PubMed  Google Scholar 

  44. Wielopolski PA, van Geuns RJ, de Feyter PJ, Oudkerk M (2000) Coronary arteries. Eur Radiol 10:12–35

    Article  CAS  PubMed  Google Scholar 

  45. Wilke NM, Jerosch-Herold M, Zenovich A, Stillman AE (1999) Magnetic resonance first-pass myocardial perfusion imaging: clinical validation and future applications. J Magn Reson Imaging 10:676–685

    Article  CAS  PubMed  Google Scholar 

  46. Wu KC, Zerhouni EA, Judd RM, Lugo-Olivieri CH, Barouch LA, Schulman SP, Blumenthal RS, Lima JA (1998) Prognostic significance of microvascular obstruction by magnetic resonance imaging in patients with acute myocardial infarction. Circulation 97:765–772

    CAS  PubMed  Google Scholar 

  47. Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, Marincek B, Luscher TF, Schalthess GK von (2001) Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation 103:2230–2235

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jörg Barkhausen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Barkhausen, J., Hunold, P. & Waltering, KU. MRI in coronary artery disease. Eur Radiol 14, 2155–2162 (2004). https://doi.org/10.1007/s00330-004-2456-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-004-2456-4

Keywords

Navigation