Superiority of prone position in free-breathing 3D coronary MRA in patients with coronary disease

J Magn Reson Imaging. 2001 Feb;13(2):185-91. doi: 10.1002/1522-2586(200102)13:2<185::aid-jmri1028>3.0.co;2-i.

Abstract

Navigator-gated and corrected 3D coronary MR angiography (MRA) allows submillimeter image acquisition during free breathing. However, cranial diaphragmatic drift and relative phase shifts of chest-wall motion are limiting factors for image quality and scanning duration. We hypothesized that image acquisition in the prone position would minimize artifacts related to chest-wall motion and suppress diaphragmatic drift. Twelve patients with radiographically-confirmed coronary artery disease and six healthy adult volunteers were studied in both the prone and the supine position during free-breathing navigator-gated and corrected 3D coronary MRA. Image quality and the diaphragmatic positions were objectively compared. In the prone position, there was a 36% improvement in signal-to-noise ratio (SNR; 15.5 +/- 2.7 vs. 11.4 +/- 2.6; P < 0.01) and a 34% improvement in CNR (12.5 +/- 3.3 vs. 9.3 +/- 2.5, P < 0.01). The prone position also resulted in a 17% improvement in coronary vessel definition (P < 0.01). Cranial end-expiratory diaphragmatic drift occurred less frequently in the prone position (23% +/- 17% vs. 40% +/- 26% supine; P <0.05), and navigator efficiency was higher. Prone coronary MRA results in improved SNR and CNR with enhanced coronary vessel definition. Cranial end-expiratory diaphragmatic drift also was reduced, and navigator efficiency was enhanced. When feasible, prone imaging is recommended for free-breathing coronary MRA.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Artifacts
  • Coronary Disease / diagnosis*
  • Feasibility Studies
  • Female
  • Humans
  • Image Enhancement*
  • Image Processing, Computer-Assisted*
  • Imaging, Three-Dimensional*
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Prone Position*
  • Sensitivity and Specificity