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      Magnetic Resonance Imaging of Coronary Arteries: Latest Technical Innovations and Clinical Experiences

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          Abstract

          Cardiovascular disease (CVD) is the leading cause of death and a major health care challenge globally. Coronary artery disease (CAD) is a primary underlying pathological process in the majority of cardiovascular disease cases. Magnetic resonance imaging (MRI) can play a potentially important role in the management of CAD as a noninvasive imaging modality without ionizing radiation, although its early promise has not been delivered because of several crucial technical limitations. However, recent innovations in MRI have reopened the door, with tremendous opportunities for multiparametric assessment of CAD including luminal stenosis, plaque burden and composition, and disease activities such as inflammation and hemorrhage. Novel MRI acquisition and reconstruction strategies now offer much increased spatial resolution and image quality and shortened examination times compared with conventional approaches. Recent clinical experiences of coronary MRI indicated the potential to improve the current management of coronary atherosclerosis, such as identifying the patients at the highest risk and evaluating therapeutic responses. In this review we discuss the latest technical advances and clinical insights in coronary MRI.

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          Most cited references 76

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          Highly efficient nonrigid motion‐corrected 3D whole‐heart coronary vessel wall imaging

          Purpose To develop a respiratory motion correction framework to accelerate free‐breathing three‐dimensional (3D) whole‐heart coronary lumen and coronary vessel wall MRI. Methods We developed a 3D flow‐independent approach for vessel wall imaging based on the subtraction of data with and without T2‐preparation prepulses acquired interleaved with image navigators. The proposed method corrects both datasets to the same respiratory position using beat‐to‐beat translation and bin‐to‐bin nonrigid corrections, producing coregistered, motion‐corrected coronary lumen and coronary vessel wall images. The proposed method was studied in 10 healthy subjects and was compared with beat‐to‐beat translational correction (TC) and no motion correction for the left and right coronary arteries. Additionally, the coronary lumen images were compared with a 6‐mm diaphragmatic navigator gated and tracked scan. Results No significant differences (P > 0.01) were found between the proposed method and the gated and tracked scan for coronary lumen, despite an average improvement in scan efficiency to 96% from 59%. Significant differences (P < 0.01) were found in right coronary artery vessel wall thickness, right coronary artery vessel wall sharpness, and vessel wall visual score between the proposed method and TC. Conclusion The feasibility of a highly efficient motion correction framework for simultaneous whole‐heart coronary lumen and vessel wall has been demonstrated. Magn Reson Med 77:1894–1908, 2017. © 2016 International Society for Magnetic Resonance in Medicine
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            Four-dimensional respiratory motion-resolved whole heart coronary MR angiography.

            Free-breathing whole-heart coronary MR angiography (MRA) commonly uses navigators to gate respiratory motion, resulting in lengthy and unpredictable acquisition times. Conversely, self-navigation has 100% scan efficiency, but requires motion correction over a broad range of respiratory displacements, which may introduce image artifacts. We propose replacing navigators and self-navigation with a respiratory motion-resolved reconstruction approach.
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              Nonrigid Motion Correction With 3D Image-Based Navigators for Coronary MR Angiography.

              To develop a retrospective nonrigid motion-correction method based on 3D image-based navigators (iNAVs) for free-breathing whole-heart coronary magnetic resonance angiography (MRA).
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                Author and article information

                Journal
                CVIA
                Cardiovascular Innovations and Applications
                CVIA
                Compuscript (Ireland )
                2009-8782
                2009-8618
                December 2016
                March 2017
                : 2
                : 1
                : 85-99
                Affiliations
                1Biomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
                2Siemens Healthcare, Chicago, IL, USA
                3Department of Bioengineering, University of California, Los Angeles, CA, USA
                Author notes
                Correspondence: Debiao Li, PhD, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd., PACT Suite 800, Los Angeles, CA 90048, USA, Tel.: +1 (424) 672-5278, Fax: +1 (310) 248-8682, E-mail: debiao.li@ 123456cshs.org
                Article
                cvia20160058
                10.15212/CVIA.2016.0058
                Copyright © 2017 Cardiovascular Innovations and Applications

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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