Skip to main content
Log in

Magnetic resonance coronary angiography using navigator echo gated real-time slice following

  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

Navigator echo gating allows for the elimination of breath-holding in MR imaging by providing a real-time monitor of respiratory position to gate image acquisition. In this study we examined the advantages and utility of real-time, navigator echo gated slice following technique in 2D magnetic resonance coronary angiography of patients with coronary artery disease. Thirteen patients with coronary artery disease were examined. MR images of the right coronary artery (RCA) were obtained parallel to the atrioventricular groove to image long sections of the RCA in a small number of slices. In-plane resolution was 0.7 × 0.9 mm and 2–6 signals were averaged to support this high spatial resolution. Targeted maximum intensity projection (MIP) images were generated from the slices to present the RCA in a single image. All patients had x-ray angiograms available for comparison with the MR images. Using the navigator echo gated real-time slice following technique, MRI successfully obtained images in 11 of 13 cases. The technique failed in two patients with irregular breathing patterns. The average length of the RCA seen in the 11 successful MR exams was 61 mm and the average length seen in the x-ray angiograms was 80 mm. Eight patients were determined to be without disease in the RCA by x-ray angiography, and all eight were correctly identified as normal on the MRI exam. In the three patients who had a sucessful MRI exam and were determined to have disease in the RCA by x-ray angiography, MRI identified the lesion in two cases. In the third case MRI indicated a discrete lesion and x-ray angiography indicated diffuse disease without a focal lesion. Navigator echo gating improves patient tolerance, provides aligned sections of coronaries over multiple slices, and allows for improved resolution through signal averaging. This preliminary patient study suggests that navigator echo gated magnetic resonance coronary angiography may play a role in evaluating coronary artery disease.

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.

Similar content being viewed by others

References

  1. Manning WJ, Li W, Edelman RR, ‘A Preliminary Report Comparing Magnetic Resonance Coronary Angiography with Conventional Angiography’, N Engl J Med 1993; 328: 828-32.

    Google Scholar 

  2. Manning WJ, Li W, Boyle NG, Edelman RR, ‘Fat Supressed Breath-hold Magnetic Resonance Coronary Angiography’, Circulation 1993; 328: 828-32.

    Google Scholar 

  3. Pennel DJ, Keegan J, Firmin, DN, Gatehouse PD, Underwood SR, Longmore DB, ‘Magnetic Resonance Imaging of Coronary Arteries: Technique and Preliminary Results’, Br J Heart 1993; 70: 315-326.

    Google Scholar 

  4. Duerinckx AJ, Urman, ‘Two-dimensional Coronary MR Angiography: Analysis of Initial Clinical Results’, Radiology 1994; 193: 731-738.

    Google Scholar 

  5. Duerinckx AJ, Atkinson DP, Mintorovitch J, Simonetti O, Urman MK, ‘Two dimensional coronary MRA: limintation and artifacts’, European Radiology 1996; 6(5): 703.

    Google Scholar 

  6. Li D, Kaushkkar S, Haacke EM, Woodard PK, Dhawale PJ, Kroeker RM, Laub G, Kuginuki Y, Gutierrez FR, ‘Coronary Arteries: Three-dimensional MR Imaging with Retrospective Respiratory Gating’, Radiology 1993; 187: 401-406.

    Google Scholar 

  7. Li D, Pachal CB, Haacke EM, Adler LP, ‘Coronary Arteries: Three-dimensional MR Imaging with Fat Supression and Magnetization Transfer Contrast’, Radiology 1993; 187: 401-406.

    Google Scholar 

  8. Wang Y, Grist TM, Korosec FR, Christy PS, Alley MT, Polzin JA, Mistretta CA, ‘Respiratory motion blurring in 3D coronary imaging’, Mag Res Med 1995; 33: 541-548.

    Google Scholar 

  9. Oshinski JN, Hofland L, Mukundan S, Dixon WT, Parks WJ, Pettigrew RI, ‘Two-Dimensional MR Angiography of the Coronary Arteries without Breath-holding’, Radiology 1996; 201: 737-743.

    Google Scholar 

  10. Ehman RL, McNamara MT, Pallack M, Hricak H, Higgins CB, ‘Magnetic Resonance Imaging with Respiratory Gating: Techniques and Advantages’, AJR 1984; 143(6): 1175-82.

    Google Scholar 

  11. Runge VM, Clanton JA, Partain CL, James AE Jr, ‘Respiratory Gating inMagnetic Resonance Imaging at 0.5 Tesla’, Radiology, 1984; 151(2): 521-3.

    Google Scholar 

  12. Wang Y, Rossman PJ, Grimm RC, Riederer SJ, Ehman RL, ‘Navigator-based real-time respiratory gating and triggering for reduction of respiration effects in coronary MR imaging,’ Radiology 1996; 198: 55-60.

    Google Scholar 

  13. Ehman RL and Felmlee JP, ‘Adaptive Technique for High-definition MR Imaging of Moving Structures’, Radiology 1989; 173: 255-263.

    Google Scholar 

  14. Danias PG, McConnell MV, Khasgiwala VC, Chuang ML, Edelman RR, Manning WJ. ‘Prospective navigator correction of image position for coronary MR angiography’, Radiology 1997; 203(3): 733-736.

    Google Scholar 

  15. Edelman RR, Manning WJ, Pearlman J, Wei L, ‘Human Coronary Arteries: Projection Angiograms Reconstructed from Breath-hold Two-dimensional MR Images’, Radiology, 1991; 181: 641-643.

    Google Scholar 

  16. Oshinski JN, Pettigrew RI, and Ku DN, ‘Turbulent Fluctuation Velocity: The most Significant Determinate in Post-stenotic Signal Loss’, Mag Res Med 1995; 33: 193-199.

    Google Scholar 

  17. Sachs TS, Meyer CH, Irarrazabal P, Hu BS, Nishimura DG, Macovski A, ‘The Diminishing Variance Algorithm for Real-Time Reduction of Motion Artifacts in MRI’, Mag Res Med 1995; 34: 412-22.

    Google Scholar 

  18. Wang Y, Riederer SJ, Ehman RL, ‘Respiratory motion of the heart: kinematics and the implications for the spatial resolution in coronary imaging,’ Mag Res Med 1995; 33: 713-719.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Oshinski, J.N., Dixon, W.T. & Pettitgrew, R.I. Magnetic resonance coronary angiography using navigator echo gated real-time slice following. Int J Cardiovasc Imaging 14, 191–199 (1998). https://doi.org/10.1023/A:1006088727033

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006088727033

Navigation