BREATH-HOLD CORONARY MR-ANGIOGRAPHY WITH VOLUME TARGETED IMAGING

PURPOSE: To illustrate a new concept for fast coronary artery screenin g with breath-hold volume targeted magnetic resonance (MR) imaging. MA TERIALS AND METHODS: Ten volunteers and 25 patients were imaged at a f ield strength of 1.5 T with an MR system with phased-array-coil recept ion and capable of echo-planar imaging. End-expiration breath-hold vol ume localization of the entire heart was performed with three-dimensio nal (3D) multishot segmented echo-planar imaging in 16-22 heartbeats. Interaction with a multiplanar reformation platform provided the optim al double-oblique volumes necessary to target seven coronary artery se gments. Each segment was evaluated with 24-mm-thick volumes and breath holds at end expiration and magnetization transfer-enhanced 3D turbo fast low-angle shot imaging in 21 heartbeats. An intravascular contras t agent was used in eight patients to improve blood-myocardium contras t for the heart volume localizer acquisitions. RESULTS: The entire cor onary tree was consistently covered in fewer than 13 breath holds. The scheme was successful in all volunteers and in 22 patients who could achieve adequate breath hold. With end-expiration acquisitions, the pr escribed 24-mm-thick volumes were reproducible for all coronary segmen ts in all cooperative subjects. CONCLUSION: Despite its status as the indisputable standard of reference for the detection of coronary arter y disease, conventional coronary angiography remains costly and highly invasive, with associated risks of major complications, including str oke and death. Breath-hold volume targeted acquisitions permit rapid l ocalization and coverage of the entire coronary tree with adequate res olution for evaluating the coronary arteries.