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

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.

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.