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Cardiac MR Angiography

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Protocols and Methodologies in Basic Science and Clinical Cardiac MRI

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Abstract

Coronary artery disease (CAD) remains the leading single cause of death in the Western world and developing countries despite improvements in prevention and advances in diagnosis and treatment. X-ray coronary angiography is the current gold standard for the detection of coronary artery stenosis, however this test is invasive and has limited value for the detection and characterization of coronary plaque. Magnetic Resonance Imaging (MRI) is a very promising non-invasive tool for comprehensive early risk assessment of CAD due to its excellent soft tissue contrast, high spatial resolution and lack of ionizing radiation. MRI is considered a gold standard for the assessment of cardiac anatomy, left ventricular function and myocardial viability from late gadolinium enhancement (LGE), and it has shown great potential for coronary lumen, plaque and thrombus/haemorrhage visualization. However, two major challenges remaining for coronary MRI are image quality degradation due to the pronounced cardiac and respiratory motion during the acquisition, and long scan times resulting from the high spatial resolution required to visualise the small calibre of the coronary arteries. This chapter reviews the technical challenges and general imaging strategies for coronary MRI and provides an overview of its current clinical use.

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Abbreviations

Ao:

Aorta

CAD:

Coronary artery disease

CT:

Computed tomography

EEG:

Electrocardiogram

FH:

Foot-head

GRAPPA:

Generalized autocalibrating partially parallel acquisitions

iNAV:

Image navigator

LAD:

Left anterior descending coronary artery

LCX:

Left circumflex coronary artery

LDL:

Low-density lipoproteins

LGE:

Late gadolinium enhancement

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

RCA:

Right coronary artery

RF:

Radiofrequency

SENSE:

Sensitivity encoding

SNR:

Signal-to-noise-ratio

SSFP:

Balanced steady-state-free-precession

SSFP:

Steady-state-free-precession

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Authors and Affiliations

  1. King’s College London, Imaging Sciences Division, St Thomas’ Hospital, 4th Floor, Lambeth Wing, London, SE1 7EH, UK

    Claudia Prieto

  2. Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, UK

    Claudia Prieto & René M. Botnar

  3. Department of Radiology, Charité-University Medicine, Berlin, Germany

    Marcus R. Makowski

  4. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    W. Yong Kim

  5. Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Warren J. Manning

  6. The British Heart Foundation Centre of Excellence, Cardiovascular Division, King’s College London, London, UK

    René M. Botnar

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  3. W. Yong Kim
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  1. Department of Cardiovascular Medicine, BMRU, Oxford, United Kingdom

    Christakis Constantinides

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Prieto, C., Makowski, M.R., Kim, W.Y., Manning, W.J., Botnar, R.M. (2018). Cardiac MR Angiography. In: Constantinides, C. (eds) Protocols and Methodologies in Basic Science and Clinical Cardiac MRI. Springer, Cham. https://doi.org/10.1007/978-3-319-53001-7_13

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