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Fusion and Visualization of 3D Magnetic Resonance Angiography and Multi-slice 2D Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Improved Diagnosis of Coronary Heart Disease
Cardiac Magnetic Resonance (CMR) imaging is the most accurate and reproducible technique for morphological imaging of the heart because of its high image resolution and tissue contrast. Recently CMR imaging has been applied to the assessment of CHD. As well as detailed anatomical information, CMR imaging can assess myocardial anatomy, contractile function, perfusion (through DCE-MRI), myocardial tissue viability (through delayed hyper-enhancement MRI), coronary artery anatomy (through MR angiography, MRA) and coronary blood-flow with accuracy similar or superior to that provided by other established tests.
CMR imaging is safe, non-invasive and does not expose patients to ionising radiation. These properties make CMR imaging an attractive method for the assessment of CHD, and which may make it the technique of choice for non-invasive imaging. In particular, non-invasive assessment of myocardial perfusion by dynamic contrast enhanced MRI (DCE-MRI) in patients with known or suspected CHD could provide important diagnostic information and contribute to patient management.
CMR may therefore more accurately and more cost effectively identify those patients with suspected CHD who require coronary revascularisation than the current 'battery of tests' available. Combining the various CMR components into a single CMR examination improves the sensitivity for the diagnosis of significant CHD over and above that of any individual component. Therefore, the technical advantages of CMR imaging and the preliminary findings do suggest that CMR imaging will be superior to any other non-invasive test for the diagnosis of significant CHD as compared to X-ray angiography.
However, imaging of myocardial perfusion by DCE-MRI is an evolving technique which has yet to become part of routine clinical practice. One of the reasons for this is the inherent incompatibility between the currently accepted gold standard (X-ray angiography) and information provided by DCE-MRI: micro-vascular perfusion assessment does not necessarily correlate to anatomical morphology of coronary arteries as assessed by X-ray angiography.
The results of the X-ray angiography are currently interpreted and correlated with DCE-MRI using a general model of coronary artery blood supply. The purpose of the proposed research is to design an algorithm for providing patient specific model of coronary artery supply using MRA, and directly relate it to the DCE-MRI findings.