Reproducibility of 3D free-breathing magnetic resonance coronary vessel wall imaging.

AIMS Although the coronary artery vessel wall can be imaged non-invasively using magnetic resonance imaging (MRI), the in vivo reproducibility of wall thickness measures has not been previously investigated. Using a refined magnetization preparation scheme, we sought to assess the reproducibility of three-dimensional (3D) free-breathing black-blood coronary MRI in vivo. METHODS AND RESULTS MRI vessel wall scans parallel to the right coronary artery (RCA) were obtained in 18 healthy individuals (age range 25-43, six women), with no known history of coronary artery disease, using a 3D dual-inversion navigator-gated black-blood spiral imaging sequence. Vessel wall scans were repeated 1 month later in eight subjects. The visible vessel wall segment and the wall thickness were quantitatively assessed using a semi-automatic tool and the intra-observer, inter-observer, and inter-scan reproducibilities were determined. The average imaged length of the RCA vessel wall was 44.5+/-7 mm. The average wall thickness was 1.6+/-0.2 mm. There was a highly significant intra-observer (r=0.97), inter-observer (r=0.94), and inter-scan (r=0.90) correlation for wall thickness (all P<0.001). There was also a significant agreement for intra-observer, inter-observer, and inter-scan measurements on Bland-Altman analysis. The intra-class correlation coefficients for intra-observer (r=0.97), inter-observer (r=0.92), and inter-scan (r=0.86) analyses were also excellent. CONCLUSION The use of black-blood free-breathing 3D MRI in conjunction with semi-automated analysis software allows for reproducible measurements of right coronary arterial vessel-wall thickness. This technique may be well-suited for non-invasive longitudinal studies of coronary atherosclerosis.

[1]  C H Lorenz,et al.  Novel real‐time R‐wave detection algorithm based on the vectorcardiogram for accurate gated magnetic resonance acquisitions , 1999, Magnetic resonance in medicine.

[2]  R. Balaban,et al.  Carotid artery atherosclerosis: in vivo morphologic characterization with gadolinium-enhanced double-oblique MR imaging initial results. , 2002, Radiology.

[3]  René M. Botnar,et al.  Double-oblique free-breathing high resolution three-dimensional coronary magnetic resonance angiography. , 1999, Journal of the American College of Cardiology.

[4]  René M. Botnar,et al.  3D coronary vessel wall imaging utilizing a local inversion technique with spiral image acquisition , 2001, Magnetic resonance in medicine.

[5]  R W Parkey,et al.  Fast short-tau inversion-recovery MR imaging. , 1991, Radiology.

[6]  E. Melhem,et al.  Black blood MR angiography using multislab three-dimensional TI-weighted turbo spin-echo technique: imaging of intracranial circulation. , 1997, AJR. American journal of roentgenology.

[7]  Samin K. Sharma,et al.  Noninvasive in vivo human coronary artery lumen and wall imaging using black-blood magnetic resonance imaging. , 2000, Circulation.

[8]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[9]  René M. Botnar,et al.  “Soap‐Bubble” visualization and quantitative analysis of 3D coronary magnetic resonance angiograms , 2002, Magnetic resonance in medicine.

[10]  René M. Botnar,et al.  Three-Dimensional Black-Blood Cardiac Magnetic Resonance Coronary Vessel Wall Imaging Detects Positive Arterial Remodeling in Patients With Nonsignificant Coronary Artery Disease , 2002, Circulation.

[11]  J. Bartko The Intraclass Correlation Coefficient as a Measure of Reliability , 1966, Psychological reports.

[12]  C. Velican,et al.  Coronary anatomy and microarchitecture as related to coronary atherosclerotic involvement. , 1989, Medecine interne.

[13]  P. Yock,et al.  Intravascular ultrasound: novel pathophysiological insights and current clinical applications. , 2001, Circulation.

[14]  Paul Schoenhagen,et al.  Effect of recombinant ApoA-I Milano on coronary atherosclerosis in patients with acute coronary syndromes: a randomized controlled trial. , 2003, JAMA.

[15]  M. McConnell,et al.  Prospective navigator correction of image position for coronary MR angiography. , 1997, Radiology.

[16]  C. Zarins,et al.  Compensatory enlargement of human atherosclerotic coronary arteries. , 1987, The New England journal of medicine.

[17]  Sheng-Kwei Song,et al.  Improved molecular imaging contrast agent for detection of human thrombus , 2003, Magnetic resonance in medicine.

[18]  D. Parker,et al.  The Voxel Sensitivity Function in Fourier Transform Imaging: Applications to Magnetic Resonance Angiography , 1995, Magnetic resonance in medicine.

[19]  D. Rader,et al.  Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. , 1999, Mayo Clinic proceedings.

[20]  W. Kerwin,et al.  Contrast‐enhanced high resolution MRI for atherosclerotic carotid artery tissue characterization , 2002, Journal of magnetic resonance imaging : JMRI.

[21]  Bruce R. Brodie,et al.  Effect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis A Randomized Controlled Trial , 2004 .

[22]  René M. Botnar,et al.  Improved coronary artery definition with T2-weighted, free-breathing, three-dimensional coronary MRA. , 1999, Circulation.

[23]  R A Deyo,et al.  Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. , 1991, Controlled clinical trials.

[24]  S. Riederer,et al.  Respiratory Motion of the Heart: Kinematics and the Implications for the Spatial Resolution in Coronary Imaging , 1995, Magnetic resonance in medicine.

[25]  P. Albert,et al.  Models for longitudinal data: a generalized estimating equation approach. , 1988, Biometrics.

[26]  R. Virmani,et al.  Effect of age, race, body surface area, heart weight and atherosclerosis on coronary artery dimensions in young males. , 1996, Atherosclerosis.