The value of single-shot black-blood MR imaging for mapping of the coronary arteries: a comparison of four different orientations during breath-holding and free breathing Agnes E. Holland*, Marc R. Engelbrecht, Jelle O. Barentsz, Frans M. J. Heijstraten, James W. Goldfarb From the Department of Radiology, University Hospital Nijmegen, Nijmegen, The Netherlands Received 12 December 2001; accepted 2 March 2002 Abstract The value of ECG-gated single-shot black-blood MR imaging for rapid visualization of the origin and course of the coronary arteries was investigated. The study population included 28 patients with known or suspected cardiac disease. ECG-gated single-shot black-blood MR acquisitions were acquired in the transverse, coronal, sagittal and LAO orientations, during free breathing and breath-holding. The origin of the left coronary artery was most frequently visualized in the coronal and LAO orientations and the origin of the right coronary artery was most frequently visualized in the LAO orientation. Overall, no significant difference was found for the visualization of the coronary artery segments and the overall image quality among acquisitions during breath-holding and free breathing. ECG-gated single-shot black-blood MR imaging (HASTE) appears to be a time-efficient and robust method for mapping of the entire coronary artery tree, without the need for breath-holding. The LAO orientation provides the most consistent visualization of the origins and major coronary artery segments. © 2002 Elsevier Science Inc. All rights reserved. Keywords: Coronary vessels; Magnetic resonance angiography; Fast imaging; Black-blood imaging 1. Introduction In the last several years considerable effort has been placed on the development of magnetic resonance angiog- raphy (MRA) techniques for imaging of the coronary arter- ies. As a result, there are currently a number of techniques available to study the major coronaries. These techniques include the two-dimensional (2D) breath-hold techniques [1–3], the three-dimensional (3D) navigator non-breath- hold techniques [4,5], and, more recently, the 3D breath- hold contrast-enhanced techniques [6,7]. Despite the great diversity in imaging strategies, one characteristic that all these techniques share is targeted acquisition of a prescribed area containing the coronary artery anatomy of interest. A targeted approach requires a scouting technique, which al- lows for rapid and accurate localization of the main coro- nary arteries. The need for such a scouting technique was also demonstrated by Kessler et al. [7]. Using a targeted contrast-enhanced 3D breath-hold acquisition, they reported three of eleven cases where the right coronary artery was located outside the imaging volume. Several studies have already demonstrated the usefulness of coronary artery scouting techniques using 3D echo-pla- nar imaging [8,9], and 2D rapid fluoroscopy [10], for local- izing the coronaries prior to targeted acquisition. However, these imaging methods are currently not readily available on most commercial MRI scanners. ECG-gated black-blood half-Fourier rapid acquisition with relaxation enhancement (RARE) imaging utilizes sin- gle-shot sequences and is therefore less sensitive to cardiac and respiratory motion [11,12]. Furthermore, these tech- niques are commercially available. Their use was recently demonstrated for imaging of several structures in the tho- racic cage, such as the pulmonary parenchyma [13], the thoracic aorta [14] and the ventricles of the heart [12]. The purpose of this study was 1) to investigate the value of ECG-gated single-shot black-blood MR imaging for rapid visualization of the origin and course of the coronary * Corresponding author. Tel.: +1-212-263-6373. E-mail address: agnes_holland@hotmail.com (A.E. Holland). Magnetic Resonance Imaging 20 (2002) 261–269 0730-725X/02/$ – see front matter © 2002 Elsevier Science Inc. All rights reserved. PII: S0730-725X(02)00492-7