Magnetic Resonance Imaging

Fig. 2.3. A non-invasive angiogram demonstrating a widely patent left internal mammary artery to the left anterior descending (white arrows) and a closed saphenous graft to the distal right coronary artery (black arrow).

allows acquisition in any anatomic plane. Furthermore, MRI does not expose the patient to radiation nor to iodinated contrast, making this the safest of the current noninvasive modalities, except in those patients with pacemakers, implantatble defibrillators or recent stent placement. The new MRI techniques may also allow quantification of velocity and flow in coronary arteries, as well as assessment of plaque morphology. MR imaging has proved successful in producing angiograms of peripheral vascular anatomy and abnormalities. MRA has already been very successful in the detection of coronary artery variants and the in the imaging of coronary stents and bypass grafts.

Suggested Reading

1. Popp RL, Fowles R, Coltart J. Cardiac anatomy viewed systematically with two-dimensional echocardiography. Chest 1979; 75:579.

2. Reeder GS, Seward JB, Tajik AJ. The role of two-dimensional echocardiography in coronary artery disease: A critical appraisal. Mayo Clin Proc 1982; 57:247.

3. Rubenson DS, Tucker CR, London E et al. Two dimensional echocardiographic

analysis of segmental left ventricular wall motion before and after coronary artery bypass surgery. Circulation 1982; 66:1025.

Jones RH, McEwan P, Newman GE et al. Accuracy of diagnosis of coronary artery disease by radionuclide measurement of left ventricular function during rest and exercise. Circulation 1981; 64:586.

Iskandarian A, Hakki AH. Radionuclide evaluation of exercise left ventricular performance in patients with coronary artery disease. Am Heart J 1985; 110:851-856.

Bonow R, Keat K, Rosing D et al. Exercise-induced ischemia in mildly symptomatic patients with coronary artery disease and preserved left ventricular function. N Engl J Med 1984; 311:1339-1345.

Noto TJ Jr, Johnson LW, Krone R et al. Cardiac catheterization 1990: a report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I), Cathet Cardiovasc Diagn 1991; 24:75-83.

Achenbach S, Moshage W, Ropers D, Nossen J, Daniel WG. Value of electron-beam computed tomography for the noninvasive detection of high-grade coronary artery stenoses and occlusions. N Engl J Med 1998; 339:1964-71. Goldin JG, Yoon HC, Greaser LE III et al. Spiral versus electron-beam CT for coronary artery calcium scoring. Radiology 2001; 221:213-21. Kim WY, Danias PG, Stuber M et al. Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med 2001; 345:1863-9. Kwok K, Kim C, Grady D et al. Meta-analysis of exercise testing to detect coronary artery disease in women. Am J Cardiol 1999; 83:660-6.

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