Two-dimensional coronary MRA: limitations and artifacts

Area of Science:

• Cardiovascular Imaging
• Magnetic Resonance Imaging

Background:

• Two-dimensional coronary MR angiography (MRA) is an emerging technique for visualizing coronary arteries.
• Assessing the diagnostic quality and potential limitations of 2D coronary MRA is crucial for its clinical adoption.

Purpose of the Study:

• To evaluate the image quality and interpretation challenges associated with two-dimensional coronary MR angiography.
• To identify specific artifacts and interpretive difficulties encountered during 2D coronary MRA examinations.

Main Methods:

• 27 subjects (12 healthy, 15 patients) underwent 2D coronary MRA using a 1.5-T imager.
• A fat-suppressed, electrocardiographically gated, breath-hold gradient-echo sequence with k-space segmentation was employed.
• Image quality and interpretive issues were systematically assessed.

Main Results:

• Common image quality degradations included ghosting (22%), blurring (22%), and incomplete fat-suppression (19%).
• Breath-holding difficulties affected 44% of subjects, leading to misregistration in 37% of optimal quality images.
• Interpretive challenges included distinguishing veins from arteries (37%) and poor visualization of the left main coronary artery (59%).

Conclusions:

• Two-dimensional coronary MRA exhibits significant image quality and interpretation problems.
• These limitations, including artifacts and anatomical visualization issues, require further technical development and validation.
• Addressing these challenges is essential prior to the routine clinical implementation of 2D coronary MRA.