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Noninvasive cineangiography by magnetic resonance global coherent free precession

Abstract

Cardiovascular disease is primarily diagnosed using invasive X-ray cineangiography. Here we introduce a new concept in magnetic resonance imaging (MRI) that, for the first time, produces similar images noninvasively and without a contrast agent. Protons in moving blood are 'tagged' every few milliseconds as they travel through an arbitrary region in space. Simultaneous with ongoing tagging of new blood, previously tagged blood is maintained in a state of global coherent free precession (GCFP), which allows acquisition of consecutive movie frames as the heart pushes blood through the vascular bed. Body tissue surrounding the moving blood is never excited and therefore remains invisible. In 18 subjects, pulsating blood could be seen flowing through three-dimensional (3D) space for distances of up to 16 cm outside the stationary excitation region. These data underscore that our approach noninvasively characterizes both anatomy and blood flow in a manner directly analogous to invasive procedures.

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Figure 1: All frames from a GCFP movie showing blood flowing out of an excitation slice at the level of the diaphragm and into the descending aorta and its branches.
Figure 2: Single movie frames from GCFP (left) and invasive catheterization (right) in the same patient.
Figure 3: Single frames from GCFP movies in the neck and head.
Figure 4: GCFP images of stenotic severity in the steady-flow phantom.
Figure 5: MRI pulse sequence that satisfies the two required GCFP conditions.

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Acknowledgements

The authors thank R. Johnson for his help with the experimental preparation and O.P. Simonetti for helpful discussions.

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Correspondence to Robert M Judd.

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Competing interests

W.G.R. is an employee of Siemens Medical Systems, which manufactures MRI scanners. R.M.J., E.L.C. and R.J.K. are inventors on a related, pending US patent.

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Rehwald, W., Chen, EL., Kim, R. et al. Noninvasive cineangiography by magnetic resonance global coherent free precession. Nat Med 10, 545–549 (2004). https://doi.org/10.1038/nm1027

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