Performance of 3D, navigator echo-gated, contrast-enhanced, magnetic resonance coronary vein imaging in patients undergoing CRT

• Type of Material: Article
• Authors: Adrian Lam, Georgia Institute of Technology; Luis F. Mora-Vieira, Emory University; Michael Hoskins, Emory University; Michael Lloyd, Emory University; John Oshinski, Emory University
• Language: English
• Date: 2014-11-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014, Springer Science+Business Media New York.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10840-014-9934-7
• Title of Journal or Parent Work: Journal of Interventional Cardiac Electrophysiology
• ISSN: 1383-875X
• Volume: 41
• Issue: 2
• Start Page: 155
• End Page: 160
• Grant/Funding Information: Adrian Lam was supported by the American Heart Association (AHA# 12PRE11030006).; This work was supported by the National Center for Advancing Translational Sciences from the National Institutes of Health (UL1TR000454) and grant R21 HL109979 from the National Institutes of Health and a grant-in-aid from the American Heart Association.
• Keywords: Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; HEART-FAILURE; MYOCARDIAL SCAR; Coronary vein; Cardiovascular System & Cardiology; MRI; X-ray venography; VENTRICULAR LEAD POSITION; CARDIAC-RESYNCHRONIZATION THERAPY; Science & Technology; CRT
• Research Categories: Engineering, Biomedical; Health Sciences, Radiology

Abstract

Materials and methods: Nineteen (19) patients undergoing cardiac resynchronization therapy (CRT) received a cardiac MRI at 1.5T 1 week before treatment. Coronary vein images were acquired using a 3D, navigator- and ECG-gated, contrast-enhanced, inversion-recovery, fast low-angle shot (FLASH) sequence. X-ray venography was performed during the CRT procedure to image the coronary venous anatomy and the LV lead location. MRI coronary vein images were graded on a 0–3 scale (0 = nonexistent, 1 = poor, 2 = good, 3 = excellent). MRI and X-ray venogram images were also graded using a binary visible/not visible scheme to compare the visibility of the coronary veins.Results: The mean visibility scores for the coronary sinus, the posterior interventricular, the posterior vein of the left ventricle, the left marginal vein, and the anterior interventricular were 3.0 ± 0.2, 2.3 ± 0.7, 1.6 ± 1.1, 1.9 ± 0.8 and 2.4 ± 0.9, respectively. When compared to X-ray venography, MRI was capable of visualizing 90 % of veins and all of the veins used for LV lead implantation. The vein used for LV lead implantation had an average vein image quality score of 1.9 on MRI images.Conclusions: Contrast-enhanced MRI was capable of visualizing 90% of the coronary venous anatomy and was able visualize the vein used for LV lead implantation in all patients.Purpose: The aims of this study were to evaluate the ability of contrast-enhanced MRI to visualize the coronary veins with validation by the gold standard, X-ray venography, and to determine whether MRI can visualize the coronary vein branch used for left ventricular (LV) lead implantation.