Читать книгу Interventional Cardiology - Группа авторов - Страница 272

CMR is evolving as an important diagnostic modality for evaluation of coronary anomalies and coronary artery aneurysms [65, 66]. Segments of anomalous coronaries that course between the aorta and pulmonary artery can cause myocardial ischemia and sudden cardiac death, especially among young adults [67, 68]. Coronary aneurysms, commonly seen in Kawasaki’s disease, are associated with morbidity and mortality [69]. Both are accurately characterized on CMR [70, 71].

CMR is not commonly used to evaluate coronary stenosis. A focal stenosis appears as signal attenuation. Several studies have evaluated the accuracy of CMR in assessing coronary artery stenosis. A recent article [72] summarized the results of these papers and discussed recent technological innovations, such as advanced motion correction and reconstruction techniques, that have improved MR coronary angiography. Two of the larger studies, with more than 100 patients each, demonstrated high sensitivity and NPV of MR coronary angiography compared to ICA [73, 74]. Coronary bypass grafts are relatively easier to image because of their minimal motion and larger lumens. The assessment of grafts has shown good correlation with quantitative X‐ray angiography for both occlusion and stenosis [75]. Currently, MR coronary angiography is being performed at large academic centers only.