Coronary Radiology Update — MR Coronary Angiography

Abstract

Magnetic resonance coronary angiography (MRCA) was introduced in 1987 when it was demonstrated that imaging of the origins of the coronary arteries from the aortic root is possible (PAULIN et al. 1987). Nowadays, MRCA can routinely visualize the proximal and middle parts of the coronary arteries and some coronary artery branches. It is an accepted noninvasive imaging modality for the evaluation of congenital coronary artery anomalies and for the determination of the patency of bypass grafts and coronary stents. However, a reliable and robust detection of coronary artery stenoses or coronary artery disease (CAD) is not possible yet, and, therefore, currently MRCA cannot replace conventional coronary angiography for the detection of stenoses. Nevertheless, there is an ongoing development of MRCA techniques and sequences, and the blind prospective detection of CAD by MRCA is also under ongoing evaluation. To date, a description of the “one” MRCA technique that is currently used in clinical practice cannot be given. The purpose of this chapter is to give an overview on the challenges and principles and to describe the different technical approaches of MRCA. The practical aspects and the clinical applications of MRCA will be described, and the current status in the detection of CAD will be summarized.