Document Detail


Three-dimensional imaging of pulmonary veins by a novel steady-state free-precession magnetic resonance angiography technique without the use of intravenous contrast agent: initial experience.
MedLine Citation:
PMID:  19561516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the feasibility of 3-dimensional (3D) steady-state free-precession (SSFP) magnetic resonance angiography (MRA) using nonselective radiofrequency excitation for imaging of pulmonary veins (PVs) without intravenous gadolinium chelate and to correlate the results with conventional contrast-enhanced MRA (CE-MRA). MATERIAL AND METHODS: Forty consecutive patients with history of atrial fibrillation underwent free-breathing respiratory navigator-gated electrocardiogram-triggered SSFP MRA without contrast administration and conventional high-resolution 3D CE-MRA of the thorax at 1.5 T. Two readers assessed both datasets for vascular definition (from 0, not visualized, to 3, excellent definition), artifacts, and ostial diameters. Statistical analysis was performed using Wilcoxon, paired t test, and kappa coefficient. RESULTS: On SSFP MRA, readers 1 and 2 graded 96.4% (160/166) and 97% (161/166) of the segments as having diagnostic visibility and sharpness, respectively (k = 0.82). On CE-MRA datasets, all segments were graded as having diagnostic visibility and sharpness by both readers (k = 0.86). No significant difference existed for visibility and sharpness of pulmonary venous segments between the datasets for each reader (P[r] > 0.05). Reader 1 (2) identified 27 (28) and 35 (32) motion artifacts on SSFP and CE-MRA datasets, respectively. No significant difference was found to exist between ostial diameters on CE-MRA and SSFP datasets (P > 0.05). CONCLUSION: Our study shows that 3D depiction of PVs without intravenous contrast is feasible with nonslice-selective SSFP MRA. This novel MRA technique may be used in certain patients with atrial fibrillation to assess the number and size of PV ostia draining to the left atrium prior to radiofrequency ablation.
Authors:
Mayil S Krishnam; Anderanik Tomasian; Sachin Malik; Aparna Singhal; Alex Sassani; Gerhard Laub; J Paul Finn; Stefan Ruehm
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  44     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  2009-10-06     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  447-53     Citation Subset:  IM    
Affiliation:
Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA 90095-7206, USA. mkrishnam@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Algorithms*
Contrast Media / administration & dosage
Female
Humans
Image Enhancement / methods*
Image Interpretation, Computer-Assisted / methods*
Imaging, Three-Dimensional / methods*
Injections, Intravenous
Magnetic Resonance Angiography / methods*
Male
Middle Aged
Pilot Projects
Pulmonary Veins / pathology*
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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