Contrast-enhanced coronary MRA

Coronary angiography with magnetic resonance imaging (MRI) has long been a goal for bringing cardiac MRI into clinical use for diagnosis of coronary artery disease. In this paper, the fundamental problems of respiratory and cardiac motion, signal-to-noise ratio, and contrast-to-noise ratio are discussed in reference to implications for coronary imaging strategies. Various methods that have been proposed to improve signal-to-noise and contrast-to-noise ratios in MR coronary imaging are presented with an emphasis on the role of T1-shortening contrast agents, both extracellular and intravascular. Although much progress has been made in recent years in techniques for imaging the coronary arteries, ultimate clinical success remains unproved. Success will depend on synergistic developments in MR acquisition techniques, respiratory compensation methods, post-processing techniques, and contrast agents to develop a workable solution for reliable coronary imaging across a wide range of patients.