Magnetic resonance coronary angiography with 3D TrueFISP: breath-hold versus respiratory gated imaging

To compare the diagnostic accuracy of coronary magnetic resonance angiography with three- dimensional (3D) trueFISP breath-hold and respiratory gated techniques for the detection of significant coronary artery stenosis. 15 patients who recently underwent elective coronary angiogram were studied and a total of 60 arteries and 48 arteries were assessed by breath-hold and respiratory gated 3D trueFISP techniques, respectively. The image quality, length of artery visualized and the presence or absence of significant coronary artery stenosis were recorded. 83.3% and 81.7% of the arteries obtained with the respiratory gated and the breath-hold techniques, respectively, had an image quality suitable for further analysis. There was no significant difference in the length of artery visualized. Sensitivity and specificity of 80%, 100% and 75% and 100%, respectively, were obtained with the breath-hold and respiratory gated techniques in detecting significant stenosis in the coronary arteries. Both techniques have moderate sensitivity and high specificity in detection of significant stenosis in the visualized segments of the major coronary arteries. However, they cannot replace conventional coronary angiogram for diagnosing coronary artery disease at present. Further studies are required to evaluate whether breath-hold approach is more efficient, therefore should be performed first and respiratory gated approach reserved for those who cannot breath-hold. MR coronary angiography can be used to identify anomalous origin of the coronary arteries. It is potentially useful in screening, diagnosis and monitoring of the progress of coronary artery disease. Different methods and pulse sequences have been used to suppress the pericardial fat, enhance the coronary artery to myocardium signal-to- noise ratio (SNR) and contrast-to-noise ratio, as well as compensate for respiratory and cardiac motions (1). Recently true-FISP (true fast imaging with steady state precession) technique has emerged as a new MR angio- graphic technique (2, 3). We compared the use of breath- hold and respiratory gated true-FISP techniques in assessing coronary artery stenosis.