Magnetic resonance measurement of coronary blood flow

Magnetic resonance (MR) flow measurement in the coronary artery can be achieved with either a breath-hold acquisition or a respiration-triggered acquisition. MR measurements of cardiac output are significantly depressed during breath-holding at deep inspiration, but the advantage is that the breath-hold method requires less scan time. Blood flow in the coronary sinus reflects the global myocardial blood flow because it represents approximately 96% of the total myocardial blood flow of the left ventricle (LV). If blood flow in the coronary sinus is measured with phase-contrast cine magnetic resonance imaging (MRI) and LV myocardial mass is measured with cine MRI, both the total myocardial blood flow and the average coronary blood flow per gram of myocardial mass can be quantified. Coronary flow reserve with volumetric MR flow measurement is measured to be within 4.2-5.0-fold. The noninvasive MR measurement of coronary flow reserve has been shown to be useful in identifying the functional significance of stenoses in the left anterior descending artery. The sensitivity and specificity of MR coronary flow velocity reserve for identifying stenosis of 70% or greater in the left main or left anterior descending artery were 100% and 83%, respectively. The MR quantification of total coronary blood flow and coronary blood flow per gram of myocardial mass seems to be an ideal method for evaluating coronary hemodynamics and may be useful in evaluating endothelial dysfunction of the coronary circulation.