Coronary Magnetic Resonance Angiography for the Detection of Coronary Stenoses
W. Yong Kim, M.D., Ph.D., Peter G. Danias, M.D., Ph.D., Matthias Stuber, Ph.D., Scott D. Flamm, M.D., Sven Plein, M.D., Eike Nagel, M.D., Susan E. Langerak, M.Sc., Oliver M. Weber, Ph.D., Erik M. Pedersen, M.D., Ph.D., Matthias Schmidt, M.D., René M. Botnar, Ph.D., and Warren J. Manning, M.D.
Background An accurate, noninvasive technique for the diagnosisof coronary disease would be an important advance. We investigatedthe accuracy of coronary magnetic resonance angiography amongpatients with suspected coronary disease in a prospective, multicenterstudy.
Methods Coronary magnetic resonance angiography was performedduring free breathing in 109 patients before elective x-raycoronary angiography, and the results of the two diagnosticprocedures were compared.
Results A total of 636 of 759 proximal and middle segments ofcoronary arteries (84 percent) were interpretable on magneticresonance angiography. In these segments, 78 (83 percent) of94 clinically significant lesions (those with a 50 percent reductionin diameter on x-ray angiography) were also detected by magneticresonance angiography. Overall, coronary magnetic resonanceangiography had an accuracy of 72 percent (95 percent confidenceinterval, 63 to 81 percent) in diagnosing coronary artery disease.The sensitivity, specificity, and accuracy for patients withdisease of the left main coronary artery or three-vessel diseasewere 100 percent (95 percent confidence interval, 97 to 100percent), 85 percent (95 percent confidence interval, 78 to92 percent), and 87 percent (95 percent confidence interval,81 to 93 percent), respectively. The negative predictive valuesfor any coronary artery disease and for left main artery orthree-vessel disease were 81 percent (95 percent confidenceinterval, 73 to 89 percent) and 100 percent (95 percent confidenceinterval, 97 to 100 percent), respectively.
Conclusions Among patients referred for their first x-ray coronaryangiogram, three-dimensional coronary magnetic resonance angiographyallows for the accurate detection of coronary artery diseaseof the proximal and middle segments. This noninvasive approachreliably identifies (or rules out) left main coronary arteryor three-vessel disease.
Despite progress in prevention and early diagnosis, coronaryartery disease remains the leading cause of death in both menand women in the United States1 and throughout the Western world.Invasive x-ray coronary angiography remains the gold standardfor the identification of clinically significant coronary arterydisease. Although numerous noninvasive tests have been developedto assist in the identification of patients with coronary arterydisease, a substantial minority of patients referred for electivediagnostic x-ray coronary angiography are found not to haveclinically significant coronary stenosis (defined as a reductionin the luminal diameter of at least 50 percent).2 A noninvasivetest that could directly assess the integrity of the coronarylumen would therefore be desirable.
Coronary magnetic resonance angiography makes possible the noninvasivevisualization of the major epicardial coronary arteries in themajority of subjects. Since the first reports by Paulin et al.3and Edelman et al.,4 coronary magnetic resonance angiographyhas undergone technological advances leading to enhanced spatialresolution and the possibility of imaging while the patientis breathing freely, but assessment of its usefulness has beenhampered by the lack of standardized hardware, software, andscanning protocols. The results from single-center studies thereforevary considerably.5,6,7,8,9,10,11,12,13,14 Coronary magneticresonance angiography15,16 performed while the patient is breathingfreely has reached sufficient technical maturity to allow morewidespread application with a standardized protocol. Therefore,we conducted a prospective, international, multicenter studyto determine the clinical usefulness of coronary magnetic resonanceangiography in the diagnosis of native-vessel coronary arterydisease.
Methods
Participating Institutions
The subjects were recruited from seven institutions: SkejbyHospital, Aarhus University Hospital, Aarhus, Denmark (7 subjects),the German Heart Institute, Berlin, Germany (18 subjects), BethIsrael Deaconess Medical Center, Boston (18 subjects), St. Luke'sEpiscopal Hospital, Houston (25 subjects), Leeds General Infirmary,Leeds, United Kingdom (23 subjects), Leiden University MedicalCenter, Leiden, the Netherlands (9 subjects), and the Universityand Eidgenoessische Technische Hochschule Zurich, Zurich, Switzerland(9 subjects). The review board at each institution approvedthe study, and written informed consent was obtained from allsubjects. In all cases, coronary magnetic resonance angiographywas performed before x-ray angiography.
Patients
The study population consisted of 109 subjects who were consecutivelyenrolled between June 24, 1999, and October 18, 2000. The subjectscould be of either sex and had to be at least 21 years of agewith sinus rhythm and with a body weight of 100 kg or less andto be scheduled to undergo elective x-ray coronary angiographyfor suspected coronary artery disease within 14 days. The exclusioncriteria were a contraindication to magnetic resonance imaging17(for example, a pacemaker, intraauricular implants, or intracranialclips), previous x-ray coronary angiography or thoracotomy,claustrophobia, orthopnea, and inability to take sublingualnitroglycerin (as a result, for example, of aortic stenosisor obstructive cardiomyopathy).
Protocol for Magnetic Resonance Angiography
Each center performed coronary magnetic resonance angiographyaccording to a standard protocol16 with use of common hardwareand software on a 1.5-T system (Gyroscan ACS-NT, Philips MedicalSystems, Best, the Netherlands) equipped with PowerTrak 6000gradients (23 mT per meter, 219 µsec rise time). The subjectswere examined with a commercial five-element cardiac synergyreceiver coil during uncoached free breathing. To compensatefor artifacts due to respiratory motion, a right hemidiaphragmaticnavigator18 with real-time slice correction19 and a 5-mm end-expiratorygating window were used. For cardiac synchronization and monitoring,three or four20 electrodes were placed on the left anteriorhemithorax of the subject with the R wave of the electrocardiogramused as a trigger for image acquisition. All coronary imageswere acquired in mid-diastole.19
Magnetic Resonance Localization Scans
The first magnetic resonance localizing scan (approximatelyone minute) employed a multistack and multislice, segmentedk-space gradient–echo sequence for localization of theheart and diaphragm in three orthogonal planes (transverse,sagittal, and coronal).15,16 From the coronal data set, a navigator-gatedtransverse three-dimensional segmented echo localizing planarscan (approximately two minutes) with 40 slices was acquiredaround the base of the heart to cover the region extending fromthe apex of the left ventricle to the pulmonary artery.16 Thisallowed identification of the course of the major right andleft coronary arteries. With the use of a three-point planscantool,16 a plane through the major axis of the proximal and middlesegments of the right coronary artery was subsequently prescribed.
Three-Dimensional Magnetic Resonance Angiography
Coronary magnetic resonance angiography was performed, aftersublingual administration of isosorbide dinitrate (2.5 mg),with the use of a three-dimensional segmented k-space gradient–echosequence (echo time, 2.2 msec; repetition time, 7.7 msec) duringfree breathing (for about 10 to 15 minutes).15,16 For contrastenhancement between blood and the surrounding myocardium andepicardial fat, a T2-weighted preparation prepulse and a frequency-selectivefat-saturation prepulse were applied.15 For the right coronaryartery, a double-oblique three-dimensional volume was imagedwith use of the coordinates prescribed by the three-point planscantool. For the left main, left anterior descending, and leftcircumflex coronary arteries, a double-oblique transverse three-dimensionalvolume with anterior–posterior and left–right angulations(5 degrees each) was imaged with the volume centered on theorigin of the left main coronary artery (as defined from thesecond localizing scan). For both the left and the right coronarysystems, the three-dimensional volumes were reconstructed to20 slices, with an individual slice thickness of 1.5 mm. A fieldof view of 360 mm and a 512-by-360 matrix yielded an in-planevoxel size of 0.7 by 1.0 mm. No signal averaging was performed.
Analysis of Coronary Magnetic Resonance Angiograms
Source coronary magnetic resonance angiograms were evaluatedat each site (before x-ray angiography) and again by consensusof two experienced investigators (from the core magnetic resonanceimaging laboratory at the Beth Israel Deaconess Medical Center)who were blinded to the patients' clinical data and the x-raydata. The original source images were analyzed by scrollingthrough individual slices from the three-dimensional data setwith the use of a commercial software package (EasyVision 4.0,Philips Medical Systems, Best, the Netherlands). Seven coronarysegments were evaluated: the left main coronary artery and theproximal and middle segments of the left anterior descendingcoronary artery (0 to 2 cm and 2 to 4 cm), the left circumflexcoronary artery (0 to 1.5 cm and 1.5 to 3 cm), and the rightcoronary artery (0 to 2 cm and 2 to 5 cm). For each segment,image quality was visually graded21 as 1, indicating poor oruninterpretable (coronary artery visible, with markedly blurredborders or edges); 2, good (coronary artery visible, with moderatelyblurred borders or edges); 3, very good (coronary artery visible,with mildly blurred borders or edges); or 4, excellent (coronaryartery visible, with sharply defined borders or edges). If thesegments were not imaged or if the image quality was gradedas poor or uninterpretable (grade 1), no further evaluationwas performed. Segments that were not visualized or that weregraded as poor or uninterpretable were not included in the subsequentanalysis. Images of good, very good, and excellent quality (grades2, 3, and 4) were further classified according to the visualassessment of the coronary-artery lumen as having no coronaryartery disease, minimal disease, or clinically significant disease(if there was prominent attenuation of the coronary-lumen signal).
Acquisition and Analysis of Coronary X-Ray Angiograms
Conventional x-ray coronary angiography was performed by standardtechniques22 and in multiple projections after sublingual administrationof isosorbide dinitrate (2.5 mg). An experienced invasive cardiologistat the institution where angiography was performed analyzedeach x-ray angiogram without knowledge of the magnetic resonancedata. Each coronary vessel was assessed, and the visual estimationof the segment and the maximal percentage reduction of the luminaldiameter for each lesion were reported. In addition, in 99 patients(91 percent), quantitative x-ray angiographic analysis was performedby an independent core laboratory (Brigham and Women's HospitalAngiographic Core Laboratory, Boston) without access to themagnetic resonance data. Quantitative angiographic analysiswas performed according to a standard algorithm,23 with clinicallysignificant disease defined as stenosis of at least 50 percentof the vessel diameter. For 10 subjects for whom quantitativeanalysis was not performed because of administrative issues(e.g., images could not be located or were unreadable), thevisual evaluation reported from the site was used for the analyses.
Statistical Analysis
The data were retained at the Beth Israel Deaconess MedicalCenter, and the primary data analysis was performed by one ofus. For each individual vessel and for each patient, the sensitivity,specificity, and accuracy (percentage of segments correctlyclassified) were determined, as well as the positive and negativepredictive values for coronary magnetic resonance angiographyas compared with x-ray coronary angiography. All data are reportedas means ±SD or rates with 95 percent confidence intervals.
Results
All subjects completed coronary magnetic resonance angiographywithout complications. Of the 109 subjects, 69 percent weremen (Table 1). The majority of the subjects had a history ofchest pain, smoking, and hypercholesterolemia. Sixty-four ofthe subjects (59 percent) had x-ray angiographic evidence ofcoronary artery disease, including 12 percent with three-vesseldisease (Table 1).
Table 1. Demographic, Clinical, and X-Ray Angiographic Characteristics of the 109 Study Patients.
The mean total magnetic resonance scanning time (including scoutimaging) was 70 minutes (median, 66; range, 33 to 145). Themedian interval between the performance of coronary magneticresonance angiography and x-ray angiography was 1 day (mean,3; range, 0 to 14), with no clinical cardiac events reportedbetween the examinations. Right coronary x-ray angiography wasnot performed in two subjects. Thus, 759 coronary segments werepotentially available for analysis. Of these, 636 (84 percent)could be assessed by coronary magnetic resonance angiography;the proportions of segments for which images could be assessedranged from 68 percent (for the middle left circumflex coronaryartery) to 93 percent (for the proximal and middle right coronaryartery) (Table 2). Coronary segments were not interpretableby magnetic resonance angiography when scans were not obtainedbecause of time constraints (39 segments), when image qualitywas poor (grade 1, 58 segments), or when the three-dimensionalvolume did not include the segment (26 segments).
Table 2. Number of Interpretable Coronary-Artery Segments and Quality of the Image on Coronary Magnetic Resonance Angiography.
In the magnetic resonance angiographic assessment of diagnosticaccuracy for each individual vessel, we included all vesselsfor which the proximal segment was graded as having an imagequality of at least 2 (good or better). In the analyses forany coronary artery disease and for left main coronary arteryor three-vessel disease, 103 subjects (94 percent) were eligibleaccording to the consensus readings, and 101 (93 percent) wereeligible according to the readings at the sites. Patients wereconsidered eligible if clinically significant coronary arterydisease identified on x-ray angiography was found in any coronaryartery segment with a readable magnetic resonance image.
The overall image quality was 2.6±0.7 (Table 2). Individualsegment lengths are shown in Figure 1. An example of a coronarymagnetic resonance angiogram and a corresponding x-ray contrastangiogram for a patient with left and right coronary arterydisease are shown in Figure 2.
Figure 2. Coronary Angiography in a 53-Year-Old Man with Exertional Chest Pain.
Panel A shows a coronary magnetic resonance angiogram (left) and a corresponding x-ray coronary angiogram (right) indicating a severe lesion at the bifurcation of the left anterior descending coronary artery and the left circumflex coronary artery, involving the left main coronary artery (solid arrows), and a more distal focal stenosis of the left circumflex coronary artery (broken arrows). Panel B shows a coronary magnetic resonance angiogram (left) and a corresponding x-ray angiogram (right) indicating two stenoses of the proximal (solid arrows) and middle (broken arrows) right coronary artery. AA denotes ascending aorta, LA left atrium, RVOT right ventricular outflow tract, PA pulmonary artery, RV right ventricle, and LV left ventricle.
Seventy-eight of 94 clinically significant coronary stenoses(83 percent) identified on x-ray angiography were correctlyidentified on magnetic resonance angiography. The sensitivityof coronary magnetic resonance angiography for identifying apatient as having clinically significant coronary artery disease,according to the consensus of the two interpreters, was 93 percent(95 percent confidence interval, 88 to 98 percent) (Table 3).All four patients who had clinically significant coronary arterydisease that was not diagnosed by coronary magnetic resonanceangiography had isolated single-vessel disease, with two (50percent) having isolated left circumflex artery disease. Inthe consensus interpretation, the overall diagnostic accuracyof coronary magnetic resonance angiography in identifying apatient as having any coronary artery disease was 72 percent(95 percent confidence interval, 63 to 81 percent), increasingto 87 percent (95 percent confidence interval, 81 to 93 percent)for the identification of a patient with left main coronaryartery or three-vessel disease. The prevalence, sensitivity,specificity, and positive and negative predictive values forindividual coronary vessels and patients according to the consensusand the site-reported interpretations are summarized in Table 3.
Table 3. Diagnostic Accuracy of Coronary Magnetic Resonance Angiography to Detect Stenoses of 50 Percent.
Discussion
In this prospective, multicenter study comparing noncontrastcoronary magnetic resonance angiography with x-ray angiographyamong patients referred for a first elective coronary angiogram,we found that coronary magnetic resonance angiography had ahigh sensitivity, negative predictive value, and overall accuracyfor detecting coronary artery disease, especially in subjectswith left main coronary artery disease or three-vessel disease.Coronary magnetic resonance angiography is not exercise-dependent,and its high negative predictive value suggests that it mayhave a role in ruling out clinically significant coronary diseasein this population of patients, among whom the prevalence ofdisease is intermediate. Indeed, 41 percent of study subjectshad no clinically significant coronary artery disease, a prevalencesimilar to that in previously published data,2 a fact that emphasizesthe need for an accurate, noninvasive technique that can ruleout clinically significant disease before invasive x-ray coronaryangiography. On the basis of the finding of no clinically significantdisease on magnetic resonance angiography, x-ray angiographycould have been avoided in 18 subjects (according to the consensusreading) or 25 subjects (according to the site reading) —those with true negative results (Table 3), or 42 to 58 percentof subjects without clinically significant coronary artery disease.With the use of standardized technology and a standardized scanningprotocol, all patients with left main coronary artery or three-vesseldisease were identified as having clinically significant coronaryartery disease. These data therefore support the use of coronarymagnetic resonance angiography to identify (or rule out) leftmain coronary artery disease or three-vessel disease reliably.Such information is clinically relevant, since surgical revascularizationin patients with such disease is associated with a more favorablelong-term survival benefit.24
The protocol for three-dimensional, noncontrast, free-breathingcoronary magnetic resonance angiography facilitated visualizationof the vast majority of the proximal and middle segments ofthe left main, left anterior descending, and right coronaryarteries. Coronary magnetic resonance angiography would detect94 percent of all patients with any coronary artery diseaseor with left main coronary artery or three-vessel disease. Theleft circumflex artery was less reliably visualized, but isolateddisease of this artery was found in only 4 percent of subjects,suggesting that the absence of clinically significant diseasein the remaining coronary system makes left circumflex arterydisease unlikely. This observation is in agreement with otherreports.25 The accuracy of coronary magnetic resonance angiographyfor the detection of coronary disease in the left circumflexartery was also low in prior single-center studies.5,6,9,13This poor accuracy may be due to the relatively small caliberand posterior location of the circumflex artery, which resultsin a lower signal-to-noise ratio because of the increased distancefrom the artery to the receiver coils.
Other minimally invasive imaging methods have recently beenadvocated for coronary-artery imaging. Electron-beam computedtomography is a highly sensitive technique for detecting calciumin the coronary arteries.2 Recent studies using multislice computedtomography in combination with iodinated contrast medium tovisualize the coronary-artery lumen demonstrated very good diagnosticaccuracy for detecting coronary artery disease when image qualitywas adequate (that is, when 70 to 80 percent of images couldbe assessed).26,27,28 A potential advantage of this method isthe acquisition of a complete data set during a single, thoughprolonged, breath-holding period (30 to 40 seconds). As comparedwith computed tomography, the magnetic resonance approach hasthe advantage of requiring no exposure to ionizing radiationor injection of a contrast agent, and it allows for more comfortablefree breathing during the entire examination. Both the magneticresonance29 and computed tomographic approaches are safe inpatients with intracoronary stents, but interpretation is difficult.
Coronary magnetic resonance angiography has already been demonstratedto be of clinical value for the assessment of anomalous coronaryartery disease, and it is often superior to x-ray coronary angiographyin delineating the course of the anomalous vessels.30,31,32,33However, coronary magnetic resonance angiography was consideredan investigational technique for the assessment of stenoticnative-vessel disease in task-force reports from Europe andthe United States in 1998.34,35 The results of single-centerinvestigations of coronary magnetic resonance angiography thatused different hardware, software, and scanning protocols havebeen variable.5,6,7,8,9,10,11,12,13,14 Single-center experience(often including patients who had previously undergone angiographyor a coronary intervention) may also be difficult to translateinto general clinical practice. Clinical acceptance of coronarymagnetic resonance angiography will probably require standardizationto ensure optimal test results. The findings of the presentmulticenter study should reflect the clinical value of coronarymagnetic resonance angiography more accurately, because we evaluateda relatively large number of patients at seven internationalinstitutions and used common hardware and software and a commonscanning protocol. Only one of the seven participating institutionshad extensive experience with coronary magnetic resonance angiography.Furthermore, the independent consensus analyses and those reportedfrom individual sites were quite similar (Table 3).
Subgroups of patients who may initially benefit from coronarymagnetic resonance angiography are likely to include patientswho present with severe left ventricular systolic dysfunctionin the absence of a clinical history of myocardial infarction.For these patients, the underlying disease process is eithersevere multivessel coronary artery disease or nonischemic cardiomyopathy.Conventional stress tests are often inaccurate in this group,resulting in frequent referral for diagnostic coronary angiography.Although this possibility was not directly tested in our study,the data suggest that coronary magnetic resonance angiographymay be able to discriminate between these two causes; thus,x-ray angiography could be avoided for those without magneticresonance evidence of coronary disease. It should be remembered,however, that coronary magnetic resonance angiography was unableto assess 16 percent of coronary segments and that 6 percentof the study patients could not be assessed for the presenceof any coronary disease or for left main coronary artery orthree-vessel disease.
Supported in part by Philips Medical Systems, Best, the Netherlands,which funded the quantitative coronary angiographic analysis(but not the selection of the analysis laboratory or data interpretation)and by an Established Investigatorship Grant from the AmericanHeart Association, Dallas (9740003N, to Dr. Manning).
Source Information
From the Cardiovascular Division, Department of Medicine (W.Y.K., P.G.D., M. Stuber, R.M.B., W.J.M.), and the Department of Radiology (W.J.M.), Beth Israel Deaconess Medical Center and Harvard Medical School, Boston; the Magnetic Resonance Center, Department of Cardiology, and Institute of Experimental Clinical Research, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark (W.Y.K., E.M.P.); Philips Medical Systems, Best, the Netherlands (M. Stuber, R.M.B.); St. Luke's Episcopal Hospital and the Texas Heart Institute, Houston (S.D.F.); the Yorkshire Heart Centre, Leeds General Infirmary, Leeds, United Kingdom (S.P.); Internal Medicine Cardiology, German Heart Institute, Berlin, Germany (E.N.); the Department of Radiology and Cardiology, Leiden University Medical Center, Leiden, the Netherlands (S.E.L.); the Institute for Biomedical Engineering, University of Zurich, and the Swiss Federal Institute of Technology Zurich, Zurich, Switzerland (O.M.W.); and the Klinik und Poliklinik für Nuklearmedizin der Universität zu Köln, Cologne, Germany (M. Schmidt).
Address reprint requests to Dr. Manning at the Beth Israel Deaconess Medical Center, 330 Brookline Ave., Boston, MA 02215, or at wmanning{at}caregroup.harvard.edu.
References
2001 Heart and stroke statistical update. Dallas: American Heart Association, 2000.
Budoff MJ, Georgiou D, Brody A, et al. Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. Circulation 1996;93:898-904. [Free Full Text]
Paulin S, von Schulthess GK, Fossel E, Krayenbuehl HP. MR imaging of the aortic root and proximal coronary arteries. AJR Am J Roentgenol 1987;148:665-670. [Free Full Text]
Edelman RR, Manning WJ, Burstein D, Paulin S. Coronary arteries: breath-hold MR angiography. Radiology 1991;181:641-643. [Free Full Text]
Manning WJ, Li W, Edelman RR. A preliminary report comparing magnetic resonance coronary angiography with conventional angiography. N Engl J Med 1993;328:828-832. [Erratum, N Engl J Med 1993;330:152.] [Free Full Text]
Duerinckx AJ, Urman MK. Two-dimensional coronary MR angiography: analysis of initial clinical results. Radiology 1994;193:731-738. [Free Full Text]
Pennell DJ, Bogren HG, Keegan J, Firmin DN, Underwood SR. Assessment of coronary artery stenosis by magnetic resonance imaging. Heart 1996;75:127-133. [Free Full Text]
Oshinski JN, Hofland L, Mukundan S Jr, Dixon WT, Parks WJ, Pettigrew RI. Two-dimensional coronary MR angiography without breath holding. Radiology 1996;201:737-743. [Free Full Text]
Post JC, van Rossum AC, Hofman MB, de Cock CC, Valk J, Visser CA. Clinical utility of two-dimensional magnetic resonance angiography in detecting coronary artery disease. Eur Heart J 1997;18:426-433. [Free Full Text]
Müller MF, Fleisch M, Kroeker R, Chatterjee T, Meier B, Vock P. Proximal coronary artery stenosis: three-dimensional MRI with fat saturation and navigator echo. J Magn Reson Imaging 1997;7:644-651. [ISI][Medline]
Woodard PK, Li D, Haacke EM, et al. Detection of coronary stenoses on source and projection images using three-dimensional MR angiography with retrospective respiratory gating: preliminary experience. AJR Am J Roentgenol 1998;170:883-888. [Free Full Text]
van Geuns RJ, Wielopolski PA, de Bruin HG, et al. MR coronary angiography with breath-hold targeted volumes: preliminary clinical results. Radiology 2000;217:270-277. [Free Full Text]
Regenfus M, Ropers D, Achenbach S, et al. Noninvasive detection of coronary artery stenosis using contrast-enhanced three-dimensional breath-hold magnetic resonance coronary angiography. J Am Coll Cardiol 2000;36:44-50. [Free Full Text]
Moustapha AI, Pereyra M, Muthupillai R, Wilson JM, Flamm SD. Coronary magnetic resonance angiography using a free-breathing T2 weighted, three-dimensional gradient echo sequence with navigator respiratory and ECG gating can be used to detect coronary artery disease. J Am Coll Cardiol 2001;37:Suppl A:380A-380A.abstract
Botnar RM, Stuber M, Danias PG, Kissinger KV, Manning WJ. Improved coronary artery definition with T2-weighted, free-breathing three-dimensional coronary MRA. Circulation 1999;99:3139-3148. [Free Full Text]
Stuber M, Botnar RM, Danias PG, et al. Double-oblique free-breathing high resolution three-dimensional coronary magnetic resonance angiography. J Am Coll Cardiol 1999;34:524-531. [Free Full Text]
Sawyer-Glover AM, Shellock FG. Pre-MRI procedure screening: recommendations and safety considerations for biomedical implants and devices. J Magn Reson Imaging 2000;12:92-106. [Erratum, J Magn Reson Imaging 2000;12:510.] [CrossRef][Medline]
Ehman RL, Felmlee JP. Adaptive technique for high-definition MR imaging of moving structures. Radiology 1989;173:255-263. [Free Full Text]
Stuber M, Botnar RM, Danias PG, Kissinger KV, Manning WJ. Submillimeter three-dimensional coronary MR angiography with real-time navigator correction: comparison of navigator locations. Radiology 1999;212:579-587. [Free Full Text]
Fischer SE, Wickline SA, Lorenz CH. Novel real-time R-wave detection algorithm based on the vectorcardiogram for accurate gated magnetic resonance acquisitions. Magn Reson Med 1999;42:361-370. [CrossRef][ISI][Medline]
McConnell MV, Khasgiwala VC, Savord BJ, et al. Comparison of respiratory suppression methods and navigator locations for MR coronary angiography. AJR Am J Roentgenol 1997;168:1369-1375. [Free Full Text]
Baim DS, Grossman W, eds. Cardiac catheterization, angiography, and intervention. 5th ed. Philadelphia: Williams & Wilkins, 1996.
van der Zwet PM, Reiber JH. A new approach for the quantification of complex lesion morphology: the gradient field transform: basic principles and validation results. J Am Coll Cardiol 1994;24:216-224. [Abstract]
Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: executive summary and recommendations: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 1999;100:1464-1480. [Free Full Text]
Hillis LD, Winniford MD. Frequency of severe (70% or more) narrowing of the right, left anterior descending, and left circumflex coronary arteries in right dominant circulations with coronary artery disease. Am J Cardiol 1987;59:358-359. [CrossRef][Medline]
Rensing BJ, Bongaerts A, van Geuns RJ, van Ooijen P, Oudkerk M, de Feyter PJ. Intravenous coronary angiography by electron beam computed tomography: a clinical evaluation. Circulation 1998;98:2509-2512. [Free Full Text]
Achenbach S, Moshage W, Ropers D, Nossen J, Daniel WG. Value of electron-beam computed tomography for the noninvasive detection of high-grade coronary-artery stenoses and occlusions. N Engl J Med 1998;339:1964-1971. [Free Full Text]
Nieman K, Oudkerk M, Rensing BJ, et al. Coronary angiography with multi-slice computed tomography. Lancet 2001;357:599-603. [CrossRef][ISI][Medline]
Hug J, Nagel E, Bornstedt A, Schnackenburg B, Oswald H, Fleck E. Coronary arterial stents: safety and artifacts during MR imaging. Radiology 2000;216:781-787. [Free Full Text]
McConnell MV, Ganz P, Selwyn AP, Li W, Edelman RR, Manning WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation 1995;92:3158-3162. [Free Full Text]
Post JC, van Rossum AC, Bronzwaer JG, et al. Magnetic resonance angiography of anomalous coronary arteries: a new gold standard for delineating the proximal course? Circulation 1995;92:3163-3171. [Free Full Text]
Taylor AM, Thorne SA, Rubens MB, et al. Coronary artery imaging in grown up congenital heart disease: complementary role of magnetic resonance and x-ray coronary angiography. Circulation 2000;101:1670-1678. [Free Full Text]
Razmi RM, Meduri A, Chun W, Rathi VK, Pohost GM. Coronary magnetic resonance angiography (CMRA): the gold standard for determining the proximal course of anomalous coronary arteries. J Am Coll Cardiol 2001;37:Suppl A:380A-380A.abstract
Budinger TF, Berson A, McVeigh ER, et al. Cardiac MR imaging: report of a working group sponsored by the National Heart, Lung, and Blood Institute. Radiology 1998;208:573-576. [Free Full Text]
Task Force of the European Society of Cardiology, Association of European Paediatric Cardiologists. The clinical role of magnetic resonance in cardiovascular disease. Eur Heart J 1998;19:19-39. [Free Full Text]
Appendix
The following investigators also participated in this study:A.D. Blankholm, Skejby Hospital, Aarhus University Hospital,Aarhus, Denmark; C. Klein, E. Fleck, J. Hug, and A. Bornstedt,German Heart Institute, Berlin, Germany; K.V. Kissinger andL.A. Goepfert, Beth Israel Deaconess Medical Center, Boston;A. Moustapha, M. Pereyra, B. Lambert, J.M. Wilson, and R. Muthupillai,St. Luke's Episcopal Hospital, Houston; M.U. Sivananthan, J.PRidgway, T.R. Jones, and T.N. Bloomer, Leeds General Infirmary,Leeds, United Kingdom; A. de Roos, P. Kunz, H. Lamb, J.W. Jukema,and E.E. van der Wall, Leiden University Medical Center, Leiden,the Netherlands; and J. Schwitter, University Hospital, Zurich,Switzerland.
Bluemke, D. A., Achenbach, S., Budoff, M., Gerber, T. C., Gersh, B., Hillis, L. D., Hundley, W. G., Manning, W. J., Printz, B. F., Stuber, M., Woodard, P. K.
(2008). Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young. Circulation
118: 586-606
[Full Text]
Chang, S., Cham, M. D., Hu, S., Wang, Y.
(2008). 3-T Navigator Parallel-Imaging Coronary MR Angiography: Targeted-Volume Versus Whole-Heart Acquisition. Am. J. Roentgenol.
191: 38-42
[Abstract][Full Text]
Sicari, R., Nihoyannopoulos, P., Evangelista, A., Kasprzak, J., Lancellotti, P., Poldermans, D., Voigt, J.-U., Zamorano, J. L., on behalf of the European Association of Echocardi,
(2008). Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr
9: 415-437
[Abstract][Full Text]
Greil, G. F, Beerbaum, P., Razavi, R., Miller, O.
(2008). Imaging the right ventricle: Non-invasive imaging. Heart
94: 803-808
[Full Text]
Wild, P. S., Funke, B., Geisler, T., Abushi, A., Zotz, R. J.
(2008). Fragment reconstruction of coronary arteries using transesophageal echocardiography for coronary diagnostics. Eur J Echocardiogr
0: jen142v1-7
[Abstract][Full Text]
Gharib, A. M., Ho, V. B., Rosing, D. R., Herzka, D. A., Stuber, M., Arai, A. E., Pettigrew, R. I.
(2008). Coronary Artery Anomalies and Variants: Technical Feasibility of Assessment with Coronary MR Angiography at 3 T. Radiology
247: 220-227
[Abstract][Full Text]
Gottlieb, I., Lima, J. A.C.
(2008). Screening High-Risk Patients With Computed Tomography Angiography. Circulation
117: 1318-1332
[Full Text]
Courtney, B. K., Munce, N. R., Anderson, K. J., Thind, A. S., Leung, G., Radau, P. E., Foster, F. S., Vitkin, I. A., Schwartz, R. S., Dick, A. J., Wright, G. A., Strauss, B. H.
(2008). Innovations in imaging for chronic total occlusions: a glimpse into the future of angiography's blind-spot. Eur Heart J
29: 583-593
[Abstract][Full Text]
Padera, R. F. Jr., Schoen, F. J.
(2008). Pathology of Cardiac Surgery. Card Surg Adult
3: 111-178
[Full Text]
Assomull, R. G, Pennell, D. J, Prasad, S. K
(2007). Cardiovascular magnetic resonance in the evaluation of heart failure. Heart
93: 985-992
[Full Text]
Saam, T., Hatsukami, T. S., Takaya, N., Chu, B., Underhill, H., Kerwin, W. S., Cai, J., Ferguson, M. S., Yuan, C.
(2007). The Vulnerable, or High-Risk, Atherosclerotic Plaque: Noninvasive MR Imaging for Characterization and Assessment. Radiology
244: 64-77
[Abstract][Full Text]
Botman, C. J., Post, H., Penn, O., Pijls, N.
(2007). Value of Magnetic Resonance Imaging, Angiography, and Fractional Flow Reserve to Evaluate the Left Main Coronary Artery After Direct Surgical Angioplasty. Ann. Thorac. Surg.
83: 490-494
[Abstract][Full Text]
Kim, W. Y., Astrup, A. S., Stuber, M., Tarnow, L., Falk, E., Botnar, R. M., Simonsen, C., Pietraszek, L., Hansen, P. R., Manning, W. J., Andersen, N. T., Parving, H.-H.
(2007). Subclinical Coronary and Aortic Atherosclerosis Detected by Magnetic Resonance Imaging in Type 1 Diabetes With and Without Diabetic Nephropathy. Circulation
115: 228-235
[Abstract][Full Text]
Henneman, M. M., Schuijf, J. D., van der Wall, E. E., Bax, J. J.
(2007). Non-invasive anatomical and functional imaging for the detection of coronary artery disease. Br Med Bull
0: ldl014v2-16
[Abstract][Full Text]
Bansmann, P. M., Priest, A. N., Muellerleile, K., Stork, A., Lund, G. K., Kaul, M. G., Adam, G.
(2007). MRI of the Coronary Vessel Wall at 3 T: Comparison of Radial and Cartesian k-Space Sampling. Am. J. Roentgenol.
188: 70-74
[Abstract][Full Text]
Hauser, T. H., Manning, W. J.
(2006). Coronary MRI: More Pretty Pictures or Present-Day Value?. J Am Coll Cardiol
48: 1951-1952
[Full Text]
Sakuma, H., Ichikawa, Y., Chino, S., Hirano, T., Makino, K., Takeda, K.
(2006). Detection of Coronary Artery Stenosis With Whole-Heart Coronary Magnetic Resonance Angiography. J Am Coll Cardiol
48: 1946-1950
[Abstract][Full Text]
Marcu, C. B., Beek, A. M., van Rossum, A. C.
(2006). Clinical applications of cardiovascular magnetic resonance imaging.. CMAJ
175: 911-917
[Abstract][Full Text]
Maksimovic, R., Seferovic, P. M., Ristic, A. D., Vujisic-Tesic, B., Simeunovic, D. S., Radovanovic, G., Matucci-Cerinic, M., Maisch, B.
(2006). Cardiac imaging in rheumatic diseases. Rheumatology (Oxford)
45: iv26-iv31
[Abstract][Full Text]
Dewey, M., Teige, F., Schnapauff, D., Laule, M., Borges, A. C., Wernecke, K.-D., Schink, T., Baumann, G., Rutsch, W., Rogalla, P., Taupitz, M., Hamm, B.
(2006). Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging.. ANN INTERN MED
145: 407-415
[Abstract][Full Text]
Muthupillai, R., Smink, J., Hong, S., Ravindran, R., Lee, V. V., Flamm, S. D.
(2006). SENSE or k-MAG to accelerate free breathing navigator-guided coronary MR angiography.. Am. J. Roentgenol.
186: 1669-1675
[Abstract][Full Text]
Pugliese, F., Cademartiri, F., van Mieghem, C., Meijboom, W. B., Malagutti, P., Mollet, N. R. A., Martinoli, C., de Feyter, P. J., Krestin, G. P.
(2006). Multidetector CT for visualization of coronary stents.. RadioGraphics
26: 887-904
[Abstract][Full Text]
Jahnke, C., Paetsch, I., Achenbach, S., Schnackenburg, B., Gebker, R., Fleck, E., Nagel, E.
(2006). Coronary MR Imaging: Breath-hold Capability and Patterns, Coronary Artery Rest Periods, and {beta}-Blocker Use. Radiology
239: 71-78
[Abstract][Full Text]
(2006). Detection of coronary complications after the arterial switch operation for transposition of the great arteries: first experience with multislice computed tomography in children.. J. Thorac. Cardiovasc. Surg.
131: 639-643
Escolar, E., Weigold, G., Fuisz, A., Weissman, N. J.
(2006). New imaging techniques for diagnosing coronary artery disease.. CMAJ
174: 487-495
[Abstract][Full Text]
Ghersin, E., Litmanovich, D., Dragu, R., Rispler, S., Lessick, J., Ofer, A., Brook, O. R., Gruberg, L., Beyar, R., Engel, A.
(2006). 16-MDCT Coronary Angiography Versus Invasive Coronary Angiography in Acute Chest Pain Syndrome: A Blinded Prospective Study. Am. J. Roentgenol.
186: 177-184
[Abstract][Full Text]
Jahnke, C., Paetsch, I., Nehrke, K., Schnackenburg, B., Gebker, R., Fleck, E., Nagel, E.
(2005). Rapid and complete coronary arterial tree visualization with magnetic resonance imaging: feasibility and diagnostic performance. Eur Heart J
26: 2313-2319
[Abstract][Full Text]
Paetsch, I., Jahnke, C., Fleck, E., Nagel, E.
(2005). Current clinical applications of stress wall motion analysis with cardiac magnetic resonance imaging. Eur J Echocardiogr
6: 317-326
[Abstract][Full Text]
Sakuma, H., Ichikawa, Y., Suzawa, N., Hirano, T., Makino, K., Koyama, N., Van Cauteren, M., Takeda, K.
(2005). Assessment of Coronary Arteries with Total Study Time of Less than 30 Minutes by Using Whole-Heart Coronary MR Angiography. Radiology
237: 316-321
[Abstract][Full Text]
Katoh, M., Stuber, M., Buecker, A., Gunther, R. W., Spuentrup, E.
(2005). Spin-labeling Coronary MR Angiography with Steady-State Free Precession and Radial k-Space Sampling: Initial Results in Healthy Volunteers. Radiology
236: 1047-1052
[Abstract][Full Text]
Budoff, M. J., Cohen, M. C., Garcia, M. J., Hodgson, J. McB., Hundley, W. G., Lima, J. A.C., Manning, W. J., Pohost, G. M., Raggi, P. M., Rodgers, G. P., Rumberger, J. A., Taylor, A. J., Creager, M. A., Hirshfeld, J. W. Jr, Lorell, B. H., Merli, G., Rodgers, G. P., Tracy, C. M., Weitz, H. H.
(2005). ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. J Am Coll Cardiol
46: 383-402
[Full Text]
Kefer, J., Coche, E., Legros, G., Pasquet, A., Grandin, C., Van Beers, B. E., Vanoverschelde, J.-L., Gerber, B. L.
(2005). Head-to-Head Comparison of Three-Dimensional Navigator-Gated Magnetic Resonance Imaging and 16-Slice Computed Tomography to Detect Coronary Artery Stenosis in Patients. J Am Coll Cardiol
46: 92-100
[Abstract][Full Text]
Fuster, V., Kim, R. J.
(2005). Frontiers in Cardiovascular Magnetic Resonance. Circulation
112: 135-144
[Full Text]
Bertrand, B., Esteve, F., Elleaume, H., Nemoz, C., Fiedler, S., Bravin, A., Berruyer, G., Brochard, T., Renier, M., Machecourt, J., Thomlinson, W., Le Bas, J.-F.
(2005). Comparison of synchrotron radiation angiography with conventional angiography for the diagnosis of in-stent restenosis after percutaneous transluminal coronary angioplasty. Eur Heart J
26: 1284-1291
[Abstract][Full Text]
Ozgun, M., Hoffmeier, A., Kouwenhoven, M., Botnar, R. M., Stuber, M., Scheld, H. H., Manning, W. J., Heindel, W., Maintz, D.
(2005). Comparison of 3D Segmented Gradient-Echo and Steady-State Free Precession Coronary MRI Sequences in Patients with Coronary Artery Disease. Am. J. Roentgenol.
185: 103-109
[Abstract][Full Text]
Namdar, M., Hany, T. F., Koepfli, P., Siegrist, P. T., Burger, C., Wyss, C. A., Luscher, T. F., von Schulthess, G. K., Kaufmann, P. A.
(2005). Integrated PET/CT for the Assessment of Coronary Artery Disease: A Feasibility Study. JNM
46: 930-935
[Abstract][Full Text]
Foo, T. K. F., Ho, V. B., Saranathan, M., Cheng, L.-q., Sakuma, H., Kraitchman, D. L., Wu, K. C., Bluemke, D. A.
(2005). Feasibility of Integrating High-Spatial-Resolution 3D Breath-hold Coronary MR Angiography with Myocardial Perfusion and Viability Examinations. Radiology
235: 1025-1030
[Abstract][Full Text]
Weinreb, J. C., Larson, P. A., Woodard, P. K., Stanford, W., Rubin, G. D., Stillman, A. E., Bluemke, D. A., Duerinckx, A. J., Dunnick, N. R., Smith, G. G.
(2005). American College of Radiology Clinical Statement on Noninvasive Cardiac Imaging. Radiology
235: 723-727
[Full Text]
Spuentrup, E., Buecker, A., Katoh, M., Wiethoff, A. J., Parsons, E. C. Jr, Botnar, R. M., Weisskoff, R. M., Graham, P. B., Manning, W. J., Gunther, R. W.
(2005). Molecular Magnetic Resonance Imaging of Coronary Thrombosis and Pulmonary Emboli With a Novel Fibrin-Targeted Contrast Agent. Circulation
111: 1377-1382
[Abstract][Full Text]
Sommer, T., Hackenbroch, M., Hofer, U., Schmiedel, A., Willinek, W. A., Flacke, S., Gieseke, J., Traber, F., Fimmers, R., Litt, H., Schild, H.
(2005). Coronary MR Angiography at 3.0 T versus That at 1.5 T: Initial Results in Patients Suspected of Having Coronary Artery Disease. Radiology
234: 718-725
[Abstract][Full Text]
Spuentrup, E., Ruebben, A., Mahnken, A., Stuber, M., Kolker, C., Nguyen, T. H., Gunther, R. W., Buecker, A.
(2005). Artifact-Free Coronary Magnetic Resonance Angiography and Coronary Vessel Wall Imaging in the Presence of a New, Metallic, Coronary Magnetic Resonance Imaging Stent. Circulation
111: 1019-1026
[Abstract][Full Text]
Fischer, M., Broeckel, U., Holmer, S., Baessler, A., Hengstenberg, C., Mayer, B., Erdmann, J., Klein, G., Riegger, G., Jacob, H. J., Schunkert, H.
(2005). Distinct Heritable Patterns of Angiographic Coronary Artery Disease in Families With Myocardial Infarction. Circulation
111: 855-862
[Abstract][Full Text]
Sousa, J. E., Costa, M. A., Tuzcu, E. M., Yadav, J. S., Ellis, S.
(2005). New Frontiers in Interventional Cardiology. Circulation
111: 671-681
[Full Text]
Mieres, J. H., Shaw, L. J., Arai, A., Budoff, M. J., Flamm, S. D., Hundley, W. G., Marwick, T. H., Mosca, L., Patel, A. R., Quinones, M. A., Redberg, R. F., Taubert, K. A., Taylor, A. J., Thomas, G. S., Wenger, N. K.
(2005). Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease: Consensus Statement From the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association. Circulation
111: 682-696
[Abstract][Full Text]
So, N M C, Lam, W W M, Li, D, Chan, A K Y, Sanderson, J E, Metreweli, C
(2005). Magnetic resonance coronary angiography with 3D TrueFISP: breath-hold versus respiratory gated imaging. Br. J. Radiol.
78: 116-121
[Abstract][Full Text]
Taylor, A. M., Dymarkowski, S., Hamaekers, P., Razavi, R., Gewillig, M., Mertens, L., Bogaert, J.
(2005). MR Coronary Angiography and Late-Enhancement Myocardial MR in Children Who Underwent Arterial Switch Surgery for Transposition of Great Arteries. Radiology
234: 542-547
[Abstract][Full Text]
Terashima, M., Meyer, C. H., Keeffe, B. G., Putz, E. J., de la Pena-Almaguer, E., Yang, P. C., Hu, B. S., Nishimura, D. G., McConnell, M. V.
(2005). Noninvasive assessment of coronary vasodilation using magnetic resonance angiography. J Am Coll Cardiol
45: 104-110
[Abstract][Full Text]
Gerber, B. L., Coche, E., Pasquet, A., Ketelslegers, E., Vancraeynest, D., Grandin, C., Van Beers, B. E., Vanoverschelde, J.-L. J.
(2005). Coronary Artery Stenosis: Direct Comparison of Four-Section Multi-Detector Row CT and 3D Navigator MR Imaging for Detection--Initial Results. Radiology
234: 98-108
[Abstract][Full Text]
Hoffmann, M. H. K., Shi, H., Manzke, R., Schmid, F. T., De Vries, L., Grass, M., Brambs, H.-J., Aschoff, A. J.
(2005). Noninvasive Coronary Angiography with 16-Detector Row CT: Effect of Heart Rate. Radiology
234: 86-97
[Abstract][Full Text]
Prasad, S. K, Assomull, R. G, Pennell, D. J
(2004). Recent developments in non-invasive cardiology. BMJ
329: 1386-1389
[Full Text]
Plein, S., Greenwood, J. P., Ridgway, J. P., Cranny, G., Ball, S. G., Sivananthan, M. U.
(2004). Assessment of non-ST-segment elevation acute coronary syndromes with cardiac magnetic resonance imaging. J Am Coll Cardiol
44: 2173-2181
[Abstract][Full Text]
Kramer, C. M.
(2004). The comprehensive approach to ischemic heart disease by cardiovascular magnetic resonance imaging: Are we there yet?. J Am Coll Cardiol
44: 2182-2184
[Full Text]
Schroeder, S, Kuettner, A, Wojak, T, Janzen, J, Heuschmid, M, Athanasiou, T, Beck, T, Burgstahler, C, Herdeg, C, Claussen, C D, Kopp, A F
(2004). Non-invasive evaluation of atherosclerosis with contrast enhanced 16 slice spiral computed tomography: results of ex vivo investigations. Heart
90: 1471-1475
[Abstract][Full Text]
Danias, P. G., Roussakis, A., Ioannidis, J. P.A.
(2004). Diagnostic performance of coronary magnetic resonance angiography as compared against conventional x-ray angiography: A meta-analysis. J Am Coll Cardiol
44: 1867-1876
[Abstract][Full Text]
Pennell, D. J., Sechtem, U. P., Higgins, C. B., Manning, W. J., Pohost, G. M., Rademakers, F. E., van Rossum, A. C., Shaw, L. J., Yucel, E. K.
(2004). Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J
25: 1940-1965
[Full Text]
Davies, J. R., Rudd, J. H., Weissberg, P. L.
(2004). Molecular and Metabolic Imaging of Atherosclerosis. JNM
45: 1898-1907
[Abstract][Full Text]
Herborn, C. U., Schmidt, M., Bruder, O., Nagel, E., Shamsi, K., Barkhausen, J.
(2004). MR Coronary Angiography with SH L 643 A: Initial Experience in Patients with Coronary Artery Disease. Radiology
233: 567-573
[Abstract][Full Text]
Lima, J. A.C., Desai, M. Y.
(2004). Cardiovascular magnetic resonance imaging: Current and emerging applications. J Am Coll Cardiol
44: 1164-1171
[Abstract][Full Text]
Edelman, R. R.
(2004). Contrast-enhanced MR Imaging of the Heart: Overview of the Literature. Radiology
232: 653-668
[Abstract][Full Text]
Jahnke, C., Paetsch, I., Schnackenburg, B., Bornstedt, A., Gebker, R., Fleck, E., Nagel, E.
(2004). Coronary MR Angiography with Steady-State Free Precession: Individually Adapted Breath-hold Technique versus Free-breathing Technique. Radiology
232: 669-676
[Abstract][Full Text]
Dhawan, S., Dharmashankar, K. C., Tak, T.
(2004). Role of Magnetic Resonance Imaging in Visualizing Coronary Arteries. Clin Med Res
2: 173-179
[Abstract][Full Text]
Flamm, S. D
(2004). High-dose dobutamine stress cardiac magnetic resonance imaging - has its time come?. Eur Heart J
25: 1183-1184
[Full Text]
Schoenhagen, P., Halliburton, S. S., Stillman, A. E., Kuzmiak, S. A., Nissen, S. E., Tuzcu, E. M., White, R. D.
(2004). Noninvasive Imaging of Coronary Arteries: Current and Future Role of Multi-Detector Row CT. Radiology
232: 7-17
[Abstract][Full Text]
Schoepf, U. J., Becker, C. R., Ohnesorge, B. M., Yucel, E. K.
(2004). CT of Coronary Artery Disease. Radiology
232: 18-37
[Abstract][Full Text]
Hoffmann, U., Millea, R., Enzweiler, C., Ferencik, M., Gulick, S., Titus, J., Achenbach, S., Kwait, D., Sosnovik, D., Brady, T. J.
(2004). Acute Myocardial Infarction: Contrast-enhanced Multi-Detector Row CT in a Porcine Model. Radiology
231: 697-701
[Abstract][Full Text]
Choi, H. S., Choi, B. W., Choe, K. O., Choi, D., Yoo, K.-J., Kim, M.-I., Kim, J.
(2004). Pitfalls, Artifacts, and Remedies in Multi- Detector Row CT Coronary Angiography. RadioGraphics
24: 787-800
[Abstract][Full Text]
Spuentrup, E., Katoh, M., Buecker, A., Manning, W. J., Schaeffter, T., Nguyen, T.-H., Kuhl, H. P., Stuber, M., Botnar, R. M., Gunther, R. W.
(2004). Free-breathing 3D Steady-State Free Precession Coronary MR Angiography with Radial k-Space Sampling: Comparison with Cartesian k-Space Sampling and Cartesian Gradient-Echo Coronary MR Angiography--Pilot Study. Radiology
231: 581-586
[Abstract][Full Text]
Achenbach, S.
(2004). Detection of coronary stenoses by multidetector computed tomography: it's all about resolution. J Am Coll Cardiol
43: 840-841
[Full Text]
Dewey, M., Lembcke, A., Enzweiler, C., Hamm, B., Rogalla, P.
(2004). Isotropic half-millimeter angiography of coronary artery bypass grafts with 16-slice computed tomography. Ann. Thorac. Surg.
77: 800-804
[Abstract][Full Text]
Mavrogeni, S., Papadopoulos, G., Douskou, M., Kaklis, S., Seimenis, I., Baras, P., Nikolaidou, P., Bakoula, C., Karanasios, E., Manginas, A., Cokkinos, D. V.
(2004). Magnetic resonance angiography isequivalent to X-Ray coronary angiography for the evaluation of coronary arteries in kawasaki disease. J Am Coll Cardiol
43: 649-652
[Abstract][Full Text]
Maintz, D., Aepfelbacher, F. C., Kissinger, K. V., Botnar, R. M., Danias, P. G., Heindel, W., Manning, W. J., Stuber, M.
(2004). Coronary MR Angiography: Comparison of Quantitative and Qualitative Data from Four Techniques. Am. J. Roentgenol.
182: 515-521
[Abstract][Full Text]
Budoff, M. J., Achenbach, S., Duerinckx, A.
(2003). Clinical utility of computed tomography and magnetic resonance techniques for noninvasive coronary angiography. J Am Coll Cardiol
42: 1867-1878
[Abstract][Full Text]
Hull, M. C., Morris, C. G., Pepine, C. J., Mendenhall, N. P.
(2003). Valvular Dysfunction and Carotid, Subclavian, and Coronary Artery Disease in Survivors of Hodgkin Lymphoma Treated With Radiation Therapy. JAMA
290: 2831-2837
[Abstract][Full Text]
Herborn, C. U., Barkhausen, J., Paetsch, I., Hunold, P., Mahler, M., Shamsi, K., Nagel, E.
(2003). Coronary Arteries: Contrast-enhanced MR Imaging with SH L 643A--Experience in 12 Volunteers. Radiology
229: 217-223
[Abstract][Full Text]
Pohost, G. M., Hung, L., Doyle, M.
(2003). Clinical Use of Cardiovascular Magnetic Resonance. Circulation
108: 647-653
[Full Text]
MacNeill, B. D., Lowe, H. C., Takano, M., Fuster, V., Jang, I.-K.
(2003). Intravascular Modalities for Detection of Vulnerable Plaque: Current Status. Arterioscler. Thromb. Vasc. Bio.
23: 1333-1342
[Abstract][Full Text]
Hejmadi, A., Sahn, D. J.
(2003). What is the most effective method of detecting anomalous coronary origin in symptomatic patients?. J Am Coll Cardiol
42: 155-157
[Full Text]
Peebles, C R
(2003). Non-invasive coronary imaging: computed tomography or magnetic resonance imaging?. Heart
89: 591-594
[Full Text]
Leber, A W, Knez, A, Becker, C, Becker, A, White, C, Thilo, C, Reiser, M, Haberl, R, Steinbeck, G
(2003). Non-invasive intravenous coronary angiography using electron beam tomography and multislice computed tomography. Heart
89: 633-639
[Abstract][Full Text]
Yang, P. C., Meyer, C. H., Terashima, M., Kaji, S., McConnell, M. V., Macovski, A. l, Pauly, J. M., Nishimura, D. G., Hu, B. S.
(2003). Spiral magnetic resonance coronary angiography with rapid real-time localization. J Am Coll Cardiol
41: 1134-1141
[Abstract][Full Text]
50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. 
