Magnetic Resonance (MR) Imaging of the cardiac venous system and MR-guided intubation of the coronary sinus in swine: A feasibility-study

Article (PDF Available)inJournal of Cardiovascular Magnetic Resonance 12(Suppl 1) · January 2010with15 Reads
DOI: 10.1186/1532-429X-12-S1-O23 · Source: DOAJ
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Journal of Cardiovascular Magnetic
Resonance
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Oral presentation
Magnetic Resonance (MR) Imaging of the cardiac venous system
and MR-guided intubation of the coronary sinus in swine: a
feasibility-study
Mirja Neizel*
1
, Nils Kraemer
2
, Jan Balzer
1
, Bernhard Schnackenburg
3
,
Malte Kelm
1
, Rolf W Guenther
2
, Harald P Kuehl
2
and Gabriele A Krombach
2
Address:
1
University Hospital Duesseldorf, Duesseldorf, Germany,
2
University Hospital Aachen, Duesseldorf, Germany and
3
Philips Medical
Systems, Hamburg, Germany
* Corresponding author
Introduction
Procedures like cardiac resynchronization therapy (CRT)
or percutanous transcatheter mitral annuloplasty where
improved 3-dimensional knowledge about cardiac and
cardiac vein anatomy is needed may benefit from mag-
netic resonance (MR)-guidance.
Purpose
The aim of this study was to visualize the coronary sinus
using MR imaging and to demonstrate the feasibility of
MR-guided intubation of the cardiac venous system (CVS)
in swine.
Methods
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 Gd-BOPTA contrast agent (130-
150 slices, voxel size 1.2 × 1.2 × 1.8 mm
3
, TR/TE 6.4/3.2,
flip angle 85°. Parallel imaging was used with a SENSE-
factor of 2. 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 non-braded Cobra-catheter.
MR-guided interventions were monitored using a steady-
state free precession real-time imaging sequence. Parame-
ters of the real-time imaging sequence were TR/TE = 2.5/
1.25 ms, flip angle 45°, slice thickness 8 mm, matrix 128
× 128 reconstructed to 256 × 256 using zero-filling. Plan-
ning of the image planes, especially for the coronary sinus,
were performed with the help of the wholeheart acquisi-
tion. Time needed was measured for MR-guided intuba-
tion of the CVS and compared to the time needed for
fluoroscopy guided intubation of the CVS.
Results
The CVS could be visualized in all animals (100%). The
diameter of the ostium of the coronary sinus was 7.6 ±
0.75 mm measured using the inversion-recovery 3-dimen-
sional steady-state free-precession balanced wholeheart
sequence. Intubation of the coronary sinus and its site
branches was also 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 min ver-
sus 8.3 ± 1.3 min; p = 0.92).
Conclusion
MR-visualization and MR-guided intubation of the coro-
nary sinus and its side branches is feasible. The feasibility
of MR-guided intubation of the CVS might have some rel-
evance for procedures like CRT, requiring improved 3-
dimensional knowledge about cardiac and cardiac vein
anatomy as well as information about function, myocar-
dial scar and asynchrony in the near future.
from 13th Annual SCMR Scientific Sessions
Phoenix, AZ, USA. 21-24 January 2010
Published: 21 January 2010
Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):O23 doi:10.1186/1532-429X-12-S1-O23
<supplement> <title> <p>Abstracts of the 13<sup>th </sup>Annua l SCMR Scientific Sessions - 2010</p> </ti tle> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement>
This abstract is available from: http://jcmr-online.com/content/12/S1/O23
© 2010 Neizel et al; licensee BioMed Central Ltd.
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