Dataset Information

Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT.

ABSTRACT: The aims of this study were to evaluate the ability of contrast-enhanced MRI to visualize the coronary veins with validation by the gold standard, X-ray venography, and to determine whether MRI can visualize the coronary vein branch used for left ventricular (LV) lead implantation.Nineteen (19) patients undergoing cardiac resynchronization therapy (CRT) received a cardiac MRI at 1.5T 1 week before treatment. Coronary vein images were acquired using a 3D, navigator- and ECG-gated, contrast-enhanced, inversion-recovery, fast low-angle shot (FLASH) sequence. X-ray venography was performed during the CRT procedure to image the coronary venous anatomy and the LV lead location. MRI coronary vein images were graded on a 0-3 scale (0?=?nonexistent, 1?=?poor, 2?=?good, 3?=?excellent). MRI and X-ray venogram images were also graded using a binary visible/not visible scheme to compare the visibility of the coronary veins.The mean visibility scores for the coronary sinus, the posterior interventricular, the posterior vein of the left ventricle, the left marginal vein, and the anterior interventricular were 3.0?±?0.2, 2.3?±?0.7, 1.6?±?1.1, 1.9?±?0.8 and 2.4?±?0.9, respectively. When compared to X-ray venography, MRI was capable of visualizing 90% of veins and all of the veins used for LV lead implantation. The vein used for LV lead implantation had an average vein image quality score of 1.9 on MRI images.Contrast-enhanced MRI was capable of visualizing 90% of the coronary venous anatomy and was able visualize the vein used for LV lead implantation in all patients.

SUBMITTER: Lam A

PROVIDER: S-EPMC4192024 | biostudies-literature | 2014 Nov

REPOSITORIES: biostudies-literature

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Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT.

Lam Adrian A Mora-Vieira Luis F LF Hoskins Michael M Lloyd Michael M Oshinski John N JN

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 20140917 2

<h4>Purpose</h4>The aims of this study were to evaluate the ability of contrast-enhanced MRI to visualize the coronary veins with validation by the gold standard, X-ray venography, and to determine whether MRI can visualize the coronary vein branch used for left ventricular (LV) lead implantation.<h4>Materials and methods</h4>Nineteen (19) patients undergoing cardiac resynchronization therapy (CRT) received a cardiac MRI at 1.5T 1 week before treatment. Coronary vein images were acquired using a ...[more]

PMID: 25227865

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Project description:The purpose of this study was to assess the accuracy of fractional blood volume (vb) estimates in low-perfused and low-vascularized tissue using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). The results of different MRI methods were compared with histology to evaluate the accuracy of these methods under clinical conditions. vb was estimated by DCE-MRI using a 3D gradient echo sequence with k-space undersampling in five muscle groups in the hind leg of 9 female pigs. Two gadolinium-based contrast agents (CA) were used: a rapidly extravasating, extracellular, gadolinium-based, low-molecular-weight contrast agent (LMCA, gadoterate meglumine) and an extracellular, gadolinium-based, albumin-binding, slowly extravasating blood pool contrast agent (BPCA, gadofosveset trisodium). LMCA data were evaluated using the extended Tofts model (ETM) and the two-compartment exchange model (2CXM). The images acquired with administration of the BPCA were used to evaluate the accuracy of vb estimation with a bolus deconvolution technique (BD) and a method we call equilibrium MRI (EqMRI). The latter calculates the ratio of the magnitude of the relaxation rate change in the tissue curve at an approximate equilibrium state to the height of the same area of the arterial input function (AIF). Immunohistochemical staining with isolectin was used to label endothelium. A light microscope was used to estimate the fractional vascular area by relating the vascular region to the total tissue region (immunohistochemical vessel staining, IHVS). In addition, the percentage fraction of vascular volume was determined by multiplying the microvascular density (MVD) with the average estimated capillary lumen, [Formula: see text], where d = 8μm is the assumed capillary diameter (microvascular density estimation, MVDE). Except for ETM values, highly significant correlations were found between most of the MRI methods investigated. In the cranial thigh, for example, the vb medians (interquartile range, IQRs) of IHVS, MVDE, BD, EqMRI, 2CXM and ETM were vb = 0.7(0.3)%, 1.1(0.4)%, 1.1(0.4)%, 1.4(0.3)%, 1.2(1.8)% and 0.1(0.2)%, respectively. Variances, expressed by the difference between third and first quartiles (IQR) were highest for the 2CXM for all muscle groups. High correlations between the values in four muscle groups-medial, cranial, lateral thigh and lower leg - estimated with MRI and histology were found between BD and EqMRI, MVDE and 2CXM and IHVS and ETM. Except for the ETM, no significant differences between the vb medians of all MRI methods were revealed with the Wilcoxon rank sum test. The same holds for all muscle regions using the 2CXM and MVDE. Except for cranial thigh muscle, no significant difference was found between EqMRI and MVDE. And except for the cranial thigh and the lower leg muscle, there was also no significant difference between the vb medians of BD and MVDE. Overall, there was good vb agreement between histology and the BPCA MRI methods and the 2CXM LMCA approach with the exception of the ETM method. Although LMCA models have the advantage of providing excellent curve fits and can in principle determine more physiological parameters than BPCA methods, they yield more inaccurate results.

Dataset Information

Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT.

Publications

Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT.

Similar Datasets

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