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Dtsch Med Wochenschr 2004; 129(50): 2733-2738
DOI: 10.1055/s-2004-836104
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Kardiologie/Radiologie
© Georg Thieme Verlag Stuttgart · New York

Ist die koronare Magnetresonanzangiographie als diagnostisches Routineverfahren schon zu empfehlen?

Is coronary magnetic resonance angiography already a clinically useful diagnostic tool?I. Klem1 , 2 , U. Sechtem1
  • 1Robert-Bosch-Krankenhaus, Abteilung für Kardiologie und Pulmologie, Stuttgart
  • 2Duke Cardiovascular Magnetic Resonance Center, DUMC- box 3934 or (for fed-ex) Duke Clinic 2L, Rm 2223, Trent Drive, Durham, NC 27710, USA
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Publikationsverlauf

eingereicht: 17.6.2004

akzeptiert: 26.10.2004

Publikationsdatum:
09. Dezember 2004 (online)

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Zusammenfassung

Die Magnetresonanztomographie (MRT) bietet die Möglichkeit, die Koronararterien nichtinvasiv und ohne den Einsatz ionisierender Strahlung darzustellen. Aufgrund des geringen Durchmessers, des kurvenreichen Verlaufes und der starken Bewegung der Koronararterien sowie der Signalüberlagerung von umgebendem Fett und Myokard ist die koronare Magnetresonanzangiographie (MRA) technisch anspruchsvoll. Im Vergleich zur invasiven katheterbasierten Koronarangiographie können derzeit nicht alle Gefäßabschnitte untersucht werden, und in den auswertbaren Abschnitten ist die Genauigkeit zur Erkennung von Stenosen noch suboptimal. Allerdings lässt sich das Vorhandensein von Koronaranomalien sowie die Durchgängigkeit von aortokoronaren Bypasses mit der MRA gut beurteilen. Die Kombination der koronaren MRA mit MRT-Protokollen zur Ischämiediagnostik hat das Potential, ein klinisch wertvolles Instrument für die Diagnostik der koronaren Herzkrankheit zu werden.

Summary

Magnetic resonance imaging (MRI) allows the evaluation of coronary arteries non-invasively and without the use of ionizing radiation. Coronary magnetic resonance angiography (MRA) is technically demanding due to the small size, tortuous course, and bulk motion of the coronary arteries as well as signal from surrounding epicardial fat and myocardium. In comparison to invasive x-ray coronary angiography not all coronary artery segments can be assessed by coronary MRA. At present the diagnostic accuracy of coronary MRA for detection of significant stenosis in coronary arteries is suboptimal. The presence of coronary anomalies and the patency of aortocoronary bypass grafts can be assessed by MRA with high diagnostic accuracy. The combination of coronary MRA with other MRI techniques for detection of ischemia has the potential to be of clinical value in the diagnostic work-up of patients with coronary artery disease.

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Prof. Dr. Udo Sechtem

Abteilung für Kardiologie und Pulmologie

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