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Coronary Vessel Wall Evaluation by Magnetic Resonance Imaging in the Multi-Ethnic Study of Atherosclerosis: Determinants of Image Quality

Malayeri, Ashkan A. MD*; Macedo, Robson MD*; Li, Debiao PhD; Chen, Shaoguang MS§; Bahrami, Hossein MD, MPH; Lai, Shenghan MD, PhD‡§; Lima, João A.C. MD; Bluemke, David A. MD, PhD*∥

Journal of Computer Assisted Tomography: January-February 2009 - Volume 33 - Issue 1 - p 1-7
doi: 10.1097/RCT.0b013e3181648606
Cardiovascular Imaging: Original Article

Coronary artery wall magnetic resonance imaging (MRI) has been developed to assess coronary lumen diameter and wall thickness. The purpose of this study was to evaluate the physiological parameters that affect the measures of coronary wall thickness using black-blood MRI pulse sequences.

Methods Eighty-seven participants (38 men and 49 women) of the Multi-Ethnic Study of Atherosclerosis were enrolled in the coronary artery wall MRI study. Cine 4-chamber imaging was used to determine the coronary artery rest period. Free-breathing whole-heart magnetic resonance angiography with motion adaptor navigator was performed to localize the coronary arteries in 64 participants. Cross-sectional free-breathing black-blood images were acquired using electrocardiogram-gated, turbo spin echo sequence. Imaging parameters were as follows: repetition time = 2 R-R intervals, time to echo = 33 milliseconds, echo train length = 13, bandwidth = 305 Hz/pixel, matrix = 416 × 416, field of view = 420 × 420 mm, and slice thickness = 4 to 5 mm.

Results Imaging was completed in 215 (92%) of 234 coronary segments; 9 participants had incomplete scans. Mean age was 62.6 ± 8.4 years (range, 45-81 years). Mean body mass index was 29.2 ± 5.9 kg/m2. A higher proportion of images with quality of "good" was seen in the right coronary artery (40.5%) compared to the left main and left anterior descending coronary arteries (31.9% and 26.4%, respectively). There was a very good agreement between observers in the image quality scores (κ = 0.79, P < 0.001). Lower heart rate, male sex, and longer coronary rest period were associated with higher image quality score (P < 0.05). Signal-to-noise ratio was higher in participants with Agatston calcium score of more than 10 in the right coronary and left main arteries (48.5 vs 69.7, P = 0.001; and 53.4 vs 61.6, P = 0.032, respectively).

Conclusion Improved depiction of the coronary artery wall with MRI is related to coronary rest period and atherosclerotic plaque burden as measured by calcium score and inversely related to heart rate. Because longer coronary artery rest periods are associated with improved image quality both for angiography with MRI and coronary artery wall imaging, heart rate-lowering methods in association with these techniques appear to be a logical application.

From the *Department of Radiology and Radiological Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD; †Department of Radiology, Northwestern University Medical School, Chicago, IL; and ‡Bloomberg School of Public Health and Departments of §Pathology and ∥Medicine, Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, MD.

Received for publication August 15, 2007; accepted November 19, 2007.

Reprints: David A. Bluemke, MD, PhD, MRI Room 143 (Nelson Basement), The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287 (e-mail:

This research was supported by R01 HL78909 and contracts N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute. A full list of participating MESA investigators and institutions can be found at

© 2009 Lippincott Williams & Wilkins, Inc.