Coronary MR angiography - A clinical experience in Japan

Magnetic resonance angiography (MRA) has been expected to provide a useful noninvasive means of assessing coronary artery disease as this disease cont inues to increase due to westernization of life style, Several Japanese inv estigators have assessed the diagnostic value of two-dimensional (2D) and 3 D coronary MRA in clinical patients evaluated for ischemic heart disease. A lmost all reports indicate a high correlation between findings on 2D MRA an d findings on conventional coronary angiography (CAG) in patients with seve re stenosis of proximal arteries. Row ever, in our study involving 153 pati ents with ischemic heart disease, 2D MRA tended to underestimate lesions in patients with moderate stenotic lesions. Furthermore, this method could no t be applied successfully in approximately 15% of our patients due to diffi culty with breath-holding. These findings indicate some of the limitations associated with breath-holding in the 2D method. Recently, several reports have described high diagnostic accuracy using respiratory-gated 3D MRA with navigator echo. Effective use of a suitable contrast agent with better spa tial and time resolution and better image reconstruction methods will enabl e 3D MRA to serve a useful role, even in screening for coronary artery dise ase. (C) 1999 Wiley-Liss, Inc.