Comparison of X‐ray fluoroscopy and interventional magnetic resonance imaging for the assessment of coronary artery stenoses in swine

The accuracy of a two‐step interventional MRI protocol to quantify coronary artery disease was compared to the clinical gold standard, X‐ray angiography. Studies were conducted in nine swine with a surgically induced stenosis in the proximal left circumflex coronary artery. The two‐step protocol consisted of catheter‐directed magnetic resonance angiography (MRA), which was first used to localize the stenosis, followed by MRI cross‐sectional images to quantify the degree of stenosis without the use of contrast agent. Line signal intensity profiles were drawn across the vessel diameter at the stenosis site and proximal to the stenosis for each data set to measure percentage stenosis for each animal. Catheter‐directed MRA successfully detected eight of nine stenoses. Cross‐sectional MRI accurately quantified each stenosis, with strong agreement to the measurements made using X‐ray fluoroscopy (intraclass correlation coefficient = 0.955; P < 0.05). This study demonstrates that in the future interventional MRI may be an alternative to X‐ray angiography for the detection and quantification of coronary artery disease. Magn Reson Med, 2005. © 2005 Wiley‐Liss, Inc.

[1]  H. Cohen,et al.  Ventricular Tachycardia with Narrow QRS Complexes (Left Posterior Fascicular Tachycardia) , 1972, Circulation.

[2]  P. Cohn,et al.  Diagnosis and prognosis of main left coronary artery obstruction. , 1972, Circulation.

[3]  W. Roberts,et al.  Accuracy of Angiographic Determination of Left Main Coronary Arterial Narrowing: Angiographic‐Histologic Correlative Analysis in 28 Patients , 1981, Circulation.

[4]  The accuracy of digital subtraction angiography for the quantification of atherosclerosis. , 1987, The British journal of radiology.

[5]  C Yuan,et al.  Phased‐Array Magnetic Resonance Imaging of the Carotid Artery Bifurcation: Preliminary Results in Healthy Volunteers and a Patient with Aherosclerotic Disease , 1995, Journal of magnetic resonance imaging : JMRI.

[6]  V. Fuster,et al.  Magnetic resonance images lipid, fibrous, calcified, hemorrhagic, and thrombotic components of human atherosclerosis in vivo. , 1996, Circulation.

[7]  J. Pauly,et al.  Background suppression with multiple inversion recovery nulling: Applications to projective angiography , 1997, Magnetic resonance in medicine.

[8]  R. Edelman,et al.  Noninvasive comprehensive characterization of renal artery stenosis by combination of STAR angiography and EPISTAR perfusion imaging , 1997, Magnetic resonance in medicine.

[9]  E Atalar,et al.  Intravascular MR-monitored balloon angioplasty: an in vivo feasibility study. , 1998, Journal of vascular and interventional radiology : JVIR.

[10]  O. Simonetti,et al.  Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. , 1999, Circulation.

[11]  Ergin Atalar,et al.  Toward MRI‐guided coronary catheterization: Visualization of guiding catheters, guidewires, and anatomy in real time , 2000, Journal of magnetic resonance imaging : JMRI.

[12]  René M. Botnar,et al.  Noninvasive Coronary Vessel Wall and Plaque Imaging With Magnetic Resonance Imaging , 2000, Circulation.

[13]  E Atalar,et al.  Real-time projection MR angiography: feasibility study. , 2000, Radiology.

[14]  R Frayne,et al.  MR-guided angioplasty of renal artery stenosis in a pig model: a feasibility study. , 2000, Journal of vascular and interventional radiology : JVIR.

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

[16]  T. Grist,et al.  Comparison of intraarterial and IV gadolinium-enhanced MR angiography with digital subtraction angiography for the detection of renal artery stenosis in pigs. , 2002, AJR. American journal of roentgenology.

[17]  Nikolaos V Tsekos,et al.  Dynamic coronary MR angiography and first‐pass perfusion with intracoronary administration of contrast agent , 2002, Journal of magnetic resonance imaging : JMRI.

[18]  Warren J Manning,et al.  Magnetic Resonance–Guided Coronary Artery Stent Placement in a Swine Model , 2002, Circulation.

[19]  Debiao Li,et al.  Reduction of transient signal oscillations in true‐FISP using a linear flip angle series magnetization preparation , 2003, Magnetic resonance in medicine.

[20]  Debiao Li,et al.  Catheter‐directed contrast‐enhanced coronary MR angiography in swine using magnetization‐prepared True‐FISP , 2003, Magnetic resonance in medicine.

[21]  Two- and three-dimensional MR coronary angiography with intraarterial injections of contrast agent in dogs: a feasibility study. , 2003, Radiology.

[22]  J. Finn,et al.  Real-Time Magnetic Resonance Imaging-Guided Coronary Catheterization in Swine , 2003, Circulation.

[23]  Debiao Li,et al.  Determination of optimal gadolinium concentration using SSFP for catheter-directed contrast-enhanced coronary MR angiography. , 2005, Academic radiology.

[24]  J. Carr,et al.  Three‐dimensional contrast‐enhanced steady‐state free precession for improved catheter‐directed coronary magnetic resonance angiography , 2005, Journal of magnetic resonance imaging : JMRI.

[25]  M. Nakamura,et al.  A newly developed X-ray transparent ameroid constrictor for study on progression of gradual coronary stenosis , 1980, Basic Research in Cardiology.