PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of heartHeartVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
Heart. 1996 February; 75(2): 127–133.
PMCID: PMC484247

Assessment of coronary artery stenosis by magnetic resonance imaging.

Abstract

OBJECTIVE: The findings of magnetic resonance and x-ray angiography were compared for assessment of coronary artery stenosis in this validation study. BACKGROUND: Magnetic resonance angiography of the coronary arteries has recently been described, but there has been no comparison with x-ray angiography of localisation or assessment of important characteristics of coronary stenosis. METHODS: A breath hold, segmented k-space, 2D gradient echo imaging technique incorporating fat suppression was used in 39 patients (55 coronary stenoses) with known coronary artery disease. RESULTS: Overall, 47 stenoses (85%) were assessed by magnetic resonance (29 of 33 stenoses in the left anterior descending artery, one of one in the left main stem, 14 of 17 in the right coronary artery, and three of four in the left circumflex artery were detected). There was close agreement between magnetic resonance and x-ray angiography for the distance of the stenosis from the arterial origin (magnetic resonance mean (SD) 27 (16) mm versus x-ray angiography 27 (16) mm, P = NS, mean difference -0.2 mm). The distance to 39 stenoses (83%) agreed to within 5 mm, with increased scatter for more distal stenoses. The severity of magnetic resonance signal loss, assessed visually at the site of stenosis, varied significantly according to the percentage diameter stenosis (F = 30, P < 0.0001); stenosis severity with severe signal loss was 89 (7)%, with partial signal was 70 (16)%, and with irregular wall only 37 (11)%, with significant differences among the three groups (P < 0.001). A significant correlation was found between the proportional magnetic resonance signal loss at the stenosis and the percentage diameter stenosis severity (r = -0.67, P < 0.0001). The length of stenosis measured by magnetic resonance (6 (3) mm) was greater than by x-ray angiography (5 (2) mm, P < 0.006, mean difference +1.1 mm). Spearman's rank test showed that there was significant overestimation of stenosis length by magnetic resonance as stenosis severity increased (rs = 0.34, P < 0.02). CONCLUSIONS: Accurate localisation of coronary stenosis and a qualitative assessment of stenosis severity are possible by magnetic resonance, but stenosis length is overestimated as severity increases, probably because of disturbed patterns of flow with turbulence distal to severe stenoses. Reasonable results for the detection of coronary artery stenosis by magnetic resonance were achieved in this highly selected population, but further progress in imaging techniques is necessary before moving towards appreciable clinical application.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Kennedy JW, Baxley WA, Bunnel IL, Gensini GG, Messer JV, Mudd JG, Noto TJ, Paulin S, Pichard AD, Sheldon WC, et al. Mortality related to cardiac catheterization and angiography. Cathet Cardiovasc Diagn. 1982;8(4):323–340. [PubMed]
  • Davis K, Kennedy JW, Kemp HG, Jr, Judkins MP, Gosselin AJ, Killip T. Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS). Circulation. 1979 Jun;59(6):1105–1112. [PubMed]
  • Manning WJ, Li W, Boyle NG, Edelman RR. Fat-suppressed breath-hold magnetic resonance coronary angiography. Circulation. 1993 Jan;87(1):94–104. [PubMed]
  • Pennell DJ, Keegan J, Firmin DN, Gatehouse PD, Underwood SR, Longmore DB. Magnetic resonance imaging of coronary arteries: technique and preliminary results. Br Heart J. 1993 Oct;70(4):315–326. [PMC free article] [PubMed]
  • Manning WJ, Li W, Edelman RR. A preliminary report comparing magnetic resonance coronary angiography with conventional angiography. N Engl J Med. 1993 Mar 25;328(12):828–832. [PubMed]
  • Duerinckx AJ, Urman MK. Two-dimensional coronary MR angiography: analysis of initial clinical results. Radiology. 1994 Dec;193(3):731–738. [PubMed]
  • Edelman RR, Wallner B, Singer A, Atkinson DJ, Saini S. Segmented turboFLASH: method for breath-hold MR imaging of the liver with flexible contrast. Radiology. 1990 Nov;177(2):515–521. [PubMed]
  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed]
  • Kent KC, Edelman RR, Kim D, Steinman TI, Porter DH, Skillman JJ. Magnetic resonance imaging: a reliable test for the evaluation of proximal atherosclerotic renal arterial stenosis. J Vasc Surg. 1991 Feb;13(2):311–318. [PubMed]
  • Owen RS, Carpenter JP, Baum RA, Perloff LJ, Cope C. Magnetic resonance imaging of angiographically occult runoff vessels in peripheral arterial occlusive disease. N Engl J Med. 1992 Jun 11;326(24):1577–1581. [PubMed]
  • Dodge JT, Jr, Brown BG, Bolson EL, Dodge HT. Lumen diameter of normal human coronary arteries. Influence of age, sex, anatomic variation, and left ventricular hypertrophy or dilation. Circulation. 1992 Jul;86(1):232–246. [PubMed]
  • Kleiman NS, Rodriguez AR, Raizner AE. Interobserver variability in grading of coronary arterial narrowings using the American College of Cardiology/American Heart Association grading criteria. Am J Cardiol. 1992 Feb 1;69(4):413–415. [PubMed]
  • White CW, Wright CB, Doty DB, Hiratza LF, Eastham CL, Harrison DG, Marcus ML. Does visual interpretation of the coronary arteriogram predict the physiologic importance of a coronary stenosis? N Engl J Med. 1984 Mar 29;310(13):819–824. [PubMed]
  • Wiener EC, Brechbiel MW, Brothers H, Magin RL, Gansow OA, Tomalia DA, Lauterbur PC. Dendrimer-based metal chelates: a new class of magnetic resonance imaging contrast agents. Magn Reson Med. 1994 Jan;31(1):1–8. [PubMed]
  • Liu YL, Riederer SJ, Rossman PJ, Grimm RC, Debbins JP, Ehman RL. A monitoring, feedback, and triggering system for reproducible breath-hold MR imaging. Magn Reson Med. 1993 Oct;30(4):507–511. [PubMed]
  • Meyer CH, Hu BS, Nishimura DG, Macovski A. Fast spiral coronary artery imaging. Magn Reson Med. 1992 Dec;28(2):202–213. [PubMed]

Articles from Heart are provided here courtesy of BMJ Publishing Group