TY - JOUR
T1 - Morphologic and functional evaluation of coronary artery bypass conduits
AU - Van Rossum, Albert C.
AU - Bedaux, W. L F
AU - Hofman, M. B M
PY - 1999/11/1
Y1 - 1999/11/1
N2 - There is clear evidence in the literature that conventional spin-echo and gradient-echo magnetic resonance imaging (MRI) is capable of assessing patency of coronary artery vein grafts. With more recently introduced breath- hold two-dimensional (2D) and contrast-enhanced 3D techniques, the predictive accuracy has further improved, with sensitivities and specificities in the 90% range. Limitations arise with regard to assessing obstructive disease and evaluating distal segments of sequential grafts, due to insufficient spatial resolution, low signal-to-noise ratio, and cardiac motion. Imaging of arterial grafts is complicated by the metallic clip artifacts. Adding information on graft flow patterns and flow reserve using velocity-encoded cine MRI may help to reduce some of the problems. Clinically, these functional measurements may become of use in non-invasive monitoring of gradually increasing graft narrowing. However, apart from a few exceptions, most patients undergo evaluation of their grafts because they are considered for a re-intervention by angioplasty or coronary artery bypass graft surgery. In these cases information on the status of the native coronary arteries is required. A broader clinical use of MRI in the evaluation of patients with coronary artery bypass grafts may therefore only be expected with further improvement in MR techniques for coronary angiography.
AB - There is clear evidence in the literature that conventional spin-echo and gradient-echo magnetic resonance imaging (MRI) is capable of assessing patency of coronary artery vein grafts. With more recently introduced breath- hold two-dimensional (2D) and contrast-enhanced 3D techniques, the predictive accuracy has further improved, with sensitivities and specificities in the 90% range. Limitations arise with regard to assessing obstructive disease and evaluating distal segments of sequential grafts, due to insufficient spatial resolution, low signal-to-noise ratio, and cardiac motion. Imaging of arterial grafts is complicated by the metallic clip artifacts. Adding information on graft flow patterns and flow reserve using velocity-encoded cine MRI may help to reduce some of the problems. Clinically, these functional measurements may become of use in non-invasive monitoring of gradually increasing graft narrowing. However, apart from a few exceptions, most patients undergo evaluation of their grafts because they are considered for a re-intervention by angioplasty or coronary artery bypass graft surgery. In these cases information on the status of the native coronary arteries is required. A broader clinical use of MRI in the evaluation of patients with coronary artery bypass grafts may therefore only be expected with further improvement in MR techniques for coronary angiography.
KW - Coronary artery graft
KW - MRI
KW - Patency
UR - http://www.scopus.com/inward/record.url?scp=0032733753&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/(SICI)1522-2586(199911)10:5<734::AID-JMRI18>3.0.CO;2-4
DO - https://doi.org/10.1002/(SICI)1522-2586(199911)10:5<734::AID-JMRI18>3.0.CO;2-4
M3 - Article
C2 - 10548783
SN - 1053-1807
VL - 10
SP - 734
EP - 740
JO - Journal of magnetic resonance imaging : JMRI
JF - Journal of magnetic resonance imaging : JMRI
IS - 5
ER -