Original ArticleMagnetic Resonance Imaging of the Cardiac Venous System and Magnetic Resonance-Guided Intubation of the Coronary Sinus in Swine A Feasibility StudyNeizel, Mirja MD*; Krämer, Nils MD†; Schütte, Adrian PhD‡; Schnackenburg, Bernhard PhD§; Krüger, Sascha PhD§; Kelm, Malte MD*; Günther, Rolf W. MD†; Kühl, Harald P. MD¶; Krombach, Gabriele A. MD†Author Information From the *Department of Cardiology, Angiology and Pulmonology, University Hospital Düsseldorf, Düsseldorf, Germany; †Department of Radiology, University Hospital Aachen, Aachen, Germany; ‡Fraunhofer Institute for Production Technology, Aachen, Germany; §Philips Medical Systems, Hamburg, Germany; and ¶Department of Cardiology, Angiology and Pulmonology, University Hospital Aachen, Aachen, Germany. Received December 16, 2009, and accepted for publication, after revision, March 18, 2010. Supported by research grants of Symbioscience (MARS Inc.), Philips and the Bundesministeriums für Wirtschaft und Technologie (BMWi), Germany: “Innonet” BMWi 16IN0461. Reprints: Gabriele A. Krombach, MD, Department of Radiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. E-mail: [email protected]. Investigative Radiology: August 2010 - Volume 45 - Issue 8 - p 502-506 doi: 10.1097/RLI.0b013e3181e45578 Buy Metrics Abstract Objectives: To visualize the coronary sinus using magnetic resonance (MR), and to demonstrate the feasibility of MR-guided intubation of the cardiac venous system (CVS) in swine. Materials and Methods: A total of 6 pigs were investigated. All experiments were performed using an interventional 1.5-Tesla MRI system. The CVS was visualized using an inversion-recovery navigator-gated whole-heart steady-state free-precession sequence after administration of gadobenate dimeglumine contrast agent. The coronary sinus was then intubated under MR-guidance with a passive MR-compatible guidewire modified by incorporation of iron oxide markers for improved visualization and a nonbraided Cobra-catheter. MR-guided interventions were monitored using a steady-state free-precession real-time imaging sequence. Time needed was measured for MR-guided intubation of the CVS and compared with the time needed for fluoroscopy guided intubation of the CVS. Results: Visualization and intubation of the coronary sinus and its site branches was feasible in all cases. Time spent for MR-guided intubation of the CVS was comparable to time spent for fluoroscopy-guided intubation (8.2 ± 2 minutes vs. 8.3 ± 1.3 minutes; P = 0.85). Conclusions: MR-visualization and MR-guided intubation of the coronary sinus and its side branches is feasible. The feasibility of MR-guided intubation of the CVS might have relevance for procedures like cardiac resynchronization therapy and percutaneous transcatheter mitral annuloplasty, requiring improved 3-dimensional knowledge about cardiac vein anatomy in the near future. © 2010 Lippincott Williams & Wilkins, Inc.