Coronary Vessel Wall 3-T MR Imaging with Time-resolved Acquisition of Phase-Sensitive Dual Inversion-Recovery (TRAPD) Technique: Initial Results in Patients with Risk Factors for Coronary Artery Disease

Abstract

To develop a technique for time-resolved acquisition of phase-sensitive dual-inversion recovery (TRAPD) coronary vessel wall magnetic resonance (MR) images, to investigate the success rate in coronary wall imaging compared with that of single-frame imaging, and to assess vessel wall thickness in healthy subjects and subjects with risk factors for coronary artery disease (CAD). Thirty-eight subjects (12 healthy subjects, 26 subjects with at least one CAD risk factor) provided informed consent for participation in this institutional review board-approved and HIPAA-compliant study. The TRAPD coronary vessel wall imaging sequence was developed and validated with a flow phantom. Time-resolved coronary artery wall images at three to five cine phases were obtained in all subjects. Qualitative and quantitative comparisons were made between TRAPD and conventional single-image wall measurements. Measurement reproducibility also was assessed. Statistical analysis was performed for all comparisons. The TRAPD sequence successfully restored the negative polarity of lumen signal and enhanced lumen wall contrast on the cine images of the flow phantom and in all subjects. Use of three to five frames increased the success rate of acquiring at least one image of good to excellent quality from 76% in single-image acquisitions to 95% with the TRAPD sequence. The difference in vessel wall thickness between healthy subjects and subjects with CAD risk factors was significant (P < .05) with the TRAPD sequence (1.07 vs 1.46 mm, respectively; 36% increase) compared with single-frame dual inversion-recovery imaging (1.24 vs 1.55 mm, respectively; 25% increase). Intraobserver, interobserver, and interexamination agreement for wall thickness measurement were 0.98, 0.97, and 0.92, respectively. TRAPD imaging of coronary arteries improved arterial wall visualization and quantitative assessment by increasing the success rate of obtaining good- to excellent-quality images and sections orthogonal to the longitudinal axis of the vessel. This also resulted in vessel wall thickness measurements that show a more distinct difference between healthy subjects and those with CAD risk factors. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12120068/-/DC1.