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Noninvasive detection of coronary artery stenosis using contrast-enhanced three-dimensional breath-hold magnetic resonance coronary angiography

Matthias Regenfus, MD^*, Dieter Ropers, MD^*, Stephan Achenbach, MD^*, Winfried Kessler, MD^*, Gerhard Laub, PhD, Werner G. Daniel, MD, FACC^* and Werner Moshage, MD^*

^* Department of Internal Medicine II, University of Erlangen-Nürnberg, Erlangen, Germany
Siemens Medical Engineering, Erlangen, Germany

View larger version (73K): [in a new window]   Figure 1 (A) Turbo FLASH (fast low angle shot) MR image shows contrast enhancement of the left atrium and the aorta after administration of gadolinium-DTPA. A region of interest (circle) for measurement of signal intensity is placed over the ascending aorta. (B) Diagram of relative signal intensity (rel. SI) in the ascending aorta over time after contrast agent administration. The contrast transit time is determined on the basis of the maximum (Max) of the curve. MR = magnetic resonance.

View larger version (89K): [in a new window]   Figure 2 Spin echo HASTE (half-Fourier turbo spin echo) MR images depicting positioning of the oblique imaging slabs along the course of the left main and left anterior descending coronary artery (A) and right and left circumflex coronary artery (B). MR = magnetic resonance.

View larger version (98K): [in a new window]   Figure 3 (A) Maximum intensity projection MR image shows contrast-enhanced MR coronary angiography of the left circumflex coronary artery (arrow) and of the right coronary artery containing a proximal stenosis (arrowhead). (B) Corresponding invasive coronary angiogram with a subtotal proximal stenosis of the right coronary artery (arrow). MR = magnetic resonance.

View larger version (101K): [in a new window]   Figure 4 (A) Maximum intensity projection MR image shows contrast-enhanced MR coronary angiography with stenosis of the proximal left anterior descending coronary artery (arrow). (B) Corresponding invasive coronary angiogram with a long distance stenosis of the left anterior descending coronary artery (arrow). MR = magnetic resonance.