Time of flight quantification of coronary flow with echo-planar MRI

Detection and quantification of flow of the left anterior descending (LAD) coronary artery in healthy volunteers are demonstrated using echo-planar imaging (EPI). A time-of-flight (TOF) model was used to derive coronary flow velocities from wash-in curves, free of cardiac wall motion contamination. Short-axis cardiac studies were performed using a gated, gradient echo EPI technique to limit the effect of cardiac wall motion on coronary vessel imaging. A series of 10 to 20 single or multislice images were acquired within a single breath-hold. Real-time cine series showed the LAD coronary artery with a detectability of 91% (n = 23) and revealed beat-to-beat variability in vessel position of a magnitude equal to or greater than its diameter. Flow velocity was measured in the proximal portion of the artery at rest and during exercise. The data demonstrated the known phasic pattern of LAD flow: Vsystole < or = 5 cm/s and peak Vdiastole = 14 +/- 3 cm/s (n = 11, V = mean laminar flow velocity). During isometric exercise, a LAD flow velocity increase (52 +/- 24%) was detected in eight of nine subjects. The capacity of the EPI TOF method to detect flow velocity changes should prove clinically useful for future assessment of coronary flow reserve.