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Coronary MR imaging: effect of timing and dose of isosorbide dinitrate administration


Hu, P; Chuang, M L; Ngo, L H; Stoeck, C T; Peters, D C; Kissinger, K V; Goddu, B; Goepfert, L A; Manning, W J; Nezafat, R (2010). Coronary MR imaging: effect of timing and dose of isosorbide dinitrate administration. Radiology, 254(2):401-409.

Abstract

PURPOSE: To quantify the effect of sublingual isosorbide dinitrate (ISDN) administration on coronary magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Written informed consent was obtained from all participants, and the HIPAA-compliant protocol was approved by the Institutional Review Board. Coronary MR imaging was performed at 1.5 T before and after administration of ISDN (2.5 or 5 mg) in 25 healthy adult volunteers (mean age, 23 years +/- 4; nine men, 16 women) with three-dimensional targeted (n = 20, randomized into four groups) or whole-heart (n = 5) acquisitions with gradient-recalled echo (GRE) or balanced steady-state free precession (SSFP) sequences. Image quality was assessed by two cardiologists on a four-point scale. Signal-to-noise ratio (SNR), vessel diameter, and vessel sharpness were characterized. A linear mixed-effects model was used for data analysis. A P value of less than .05 was considered to indicate a significant difference.

RESULTS: The maximum SNR enhancement with 5 mg of ISDN (GRE: 22.0% +/- 10.7%; SSFP: 20.1% +/- 6.0%) was similar (P > .05) to that with 2.5 mg (GRE: 21.9% +/- 5.4%; SSFP: 19.1% +/- 3.0%). However, the time to maximum SNR enhancement for the 5-mg dose (15.5 minutes +/- 6.0) was earlier (P < .01) than that for 2.5 mg (23.5 minutes +/- 6.7). The increase in vessel diameter with 5 mg of ISDN was greater than that with 2.5 mg (P < .05 for both GRE and SSFP sequences). The coronary images were sharper after ISDN administration (P < .03). Subjective image quality score significantly improved after ISDN administration for GRE images (P < .05 for both doses) but was similar for SSFP images (P = .24 for 2.5 mg; P = .27 for 5 mg). Whole-heart coronary SNR was improved about 10% after ISDN administration (P < .05).

CONCLUSION: Sublingual ISDN improves coronary MR imaging SNR. Practitioners need to consider the dose and temporal effects of ISDN when performing coronary MR imaging.

Abstract

PURPOSE: To quantify the effect of sublingual isosorbide dinitrate (ISDN) administration on coronary magnetic resonance (MR) imaging.

MATERIALS AND METHODS: Written informed consent was obtained from all participants, and the HIPAA-compliant protocol was approved by the Institutional Review Board. Coronary MR imaging was performed at 1.5 T before and after administration of ISDN (2.5 or 5 mg) in 25 healthy adult volunteers (mean age, 23 years +/- 4; nine men, 16 women) with three-dimensional targeted (n = 20, randomized into four groups) or whole-heart (n = 5) acquisitions with gradient-recalled echo (GRE) or balanced steady-state free precession (SSFP) sequences. Image quality was assessed by two cardiologists on a four-point scale. Signal-to-noise ratio (SNR), vessel diameter, and vessel sharpness were characterized. A linear mixed-effects model was used for data analysis. A P value of less than .05 was considered to indicate a significant difference.

RESULTS: The maximum SNR enhancement with 5 mg of ISDN (GRE: 22.0% +/- 10.7%; SSFP: 20.1% +/- 6.0%) was similar (P > .05) to that with 2.5 mg (GRE: 21.9% +/- 5.4%; SSFP: 19.1% +/- 3.0%). However, the time to maximum SNR enhancement for the 5-mg dose (15.5 minutes +/- 6.0) was earlier (P < .01) than that for 2.5 mg (23.5 minutes +/- 6.7). The increase in vessel diameter with 5 mg of ISDN was greater than that with 2.5 mg (P < .05 for both GRE and SSFP sequences). The coronary images were sharper after ISDN administration (P < .03). Subjective image quality score significantly improved after ISDN administration for GRE images (P < .05 for both doses) but was similar for SSFP images (P = .24 for 2.5 mg; P = .27 for 5 mg). Whole-heart coronary SNR was improved about 10% after ISDN administration (P < .05).

CONCLUSION: Sublingual ISDN improves coronary MR imaging SNR. Practitioners need to consider the dose and temporal effects of ISDN when performing coronary MR imaging.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Engineering
Dewey Decimal Classification:170 Ethics
610 Medicine & health
Language:English
Date:2010
Deposited On:10 Feb 2011 14:21
Last Modified:20 Aug 2017 23:54
Publisher:Radiological Society of North America
ISSN:0033-8419
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1148/radiol.09090483
PubMed ID:20093512

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