Magnetic resonance imaging planes for the 3-dimensional characterisation of human coronary arteries

We report a magnetic resonance imaging study which developed a consistent hierarchy of imaging planes for examination of the origins, courses and principal branches of the main coronary arteries of prepared human cadaveric hearts. The reference longitudinal axis was chosen between the aortic valve and the apex of the left ventricle. A series of transverse planes then successfully visualised the ostia of the left and right coronary arteries; the left main coronary, its bifurcation, and the left anterior descending artery for a distance 24 mm distal to its origin were clearly distinct in successively posterior sections as was the emergence and course of the right coronary artery. Further sections were derived from an axis that joined the posterior aspects of the left and right coronary artery ostia seen in cross-section, which demonstrated the origins of these arteries. They also traced the circumflex artery 30 mm beyond its point of emergence and demonstrated the course of the right coronary artery between the right ventricle and right atrium. The anatomical identifications were confirmed in selective 3-dimensional reconstructions of the cardiac anatomy around the aortic root and pulmonary artery origin. The orthogonal anatomical arrangements of the left and right coronary artery arterial trees thus permit a consistent set of imaging planes useful for the visualisation of all the major branches in a static heart in vitro. This may offer an approach useful for clinical imaging of human coronary vessels in vivo in the moving heart.