Coronary MR angiography.

摘要: Atherosclerosis, specifically coronary artery disease, is the most common cause of adult mortality in Western Hemisphere. Cardiac imaging represents an enormous percentage all diagnostic procedures. In 1993, estimated US $1.67 billion (or 32% costs for imaging) was spent United States by Medicare (Part B) reimbursement 10 procedures that are primarily cardiovascular nature. 84 Atherosclerosis remains elusive, progressive, and devastating despite investment research dollars government industry. Invasive selective angiography has long been still gold standard defining site severity stenotic lesions arteries. The functional significance can be determined with myocardial perfusion tests without stress using either nuclear cardiology, echocardiography, or recently MR imaging. more recent literature, importance mechanisms involved plaque formation rupture as well thrombus emphasized. Plaque histology stability should critical factors predicting a small lesion future events. Nevertheless, day-to-day practice traditional criteria stenosis physiologic (coronary flow reserve) routinely used. Thus, clinical there need to image vessel's lumen exclude presence significant lesions. Today, conventional x-ray used almost exclusively direct visualization lumen. Intravascular ultrasound provided alternative but very invasive. 110 Noninvasive alternatives, such echocardiography (for infants some pediatric patients), electron-beam CT (EBCT) angiography, being evaluated. EBCT offers good solution, although it requires use radiation injection potentially harmful iodinated contrast agent. 2,3,4,21,107,141,153,154,157 Coronary less invasive; wider patient population (e.g., those renal failure); excluded others patients pacemakers, so forth). Efforts made teach performance point where many settings existing commercial scanners pulse sequences. 36 cardiac general received lot attention several medical societies (such North American Society Imaging Cardiovascular Magnetic Resonance) other groups now organize educational symposia increase numbers users who perform these studies. 142 Recent dramatic improvements technology (i.e., newer better sequences) this new trend end-users (radiologists cardiologists) both important. This article reflects on trends subfield role discussed 1 year ago Journal Roentgenology Lee Rogers, Editor-in-Chief. 143 Dr. Rogers pointed out difficult technically demanding, not impossible. Neither nor have sufficiently solved their inherent problems make noninvasive reality. But whenever procedure (even if perfect) replaces invasive one, number examinations potential increasing dramatically. There thus market angiography. manufacturers extremely interested market. Potential turf battles between radiologists cardiologists may erupt given revenues. One also forget work-up disease total atherosclerotic burden aorta, carotid, femoral arteries predictor disease. A correlation shown one arterial bed involvement vessels. 82 opens imagers screening ischemic heart beyond already established calcium screening. Measuring intimal-medial wall thickness carotid easily performed radiology practices could become important parameter, besides factors, early prediction It we keep ourselves trained informed latest advances continue participate But, order do this, knowledgeable about angiographic sequences available today scanners. Radiologists prepared work applications. article, describe techniques developed tested preclinical trials. We do, however, radiologist yet specialist our view seem likely provide results hands majority users.