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Biomedical subjects

B Schnackenburg

Publications and source records attributed to B Schnackenburg.

At least 19 recordsLinked to original sources

Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization.

This study compared different magnetic resonance imaging (MRI) methods with Tl(201) single photon emission computerized tomography (SPECT) and the "gold standard" for viability assessment, functional recovery after coronary artery bypass grafting (CABG). Twenty patients (64+/-7.3 years) with severely impaired left ventricular function (ejection fraction [EF] 28.6+/-8.7%) underwent MRI and SPECT before and 6 months after CABG. Wall-motion abnormalities were assessed by stress cine MRI using low-dose dobutamine. A segment with a nonreversible defect in Tl(201)-SPECT and a delayed enhancement (DE) in an area >50% of the entire segment, as well as an end-diastolic wall thickness <6 mm, was defined as nonviable. The mean postoperative EF (n=20) improved slightly from 28.6+/-8.7% to 32.2+/-12.4% (not significant). Using the Tl(201)-SPECT as the reference method, end-diastolic wall thickness, MRI-DE, and stress MRI showed high sensitivity of 94%, 93%, and 84%, respectively, but low specificities. Using the recovery of contractile function 6 months after CABG as the gold standard, MRI-DE showed an even higher sensitivity of 99%, end-diastolic wall thickness 96%, stress MRI 88%, and Tl(201)-SPECT 86%. MRI-DE showed advantages compared with the widely used Tl(201)-SPECT and all other MRI methods for predicting myocardial recovery after CABG.

Aged↗

MR coronary artery imaging with 3D motion adapted gating (MAG) in comparison to a standard prospective navigator technique.

Magnetic resonance coronary angiography (MRCA) has been proven to be feasible for imaging of the proximal and medial portions of the three main coronary arteries. Free breathing techniques allow for high resolution imaging but prolong scan time. This could potentially be shortened by improving the efficiency, robustness and accuracy of the navigator gating algorithm. Aim of this study was to determine the feasibility, efficiency, and image quality of a new motion compensation algorithm (3D-MAG) for coronary artery imaging with navigator techniques. In 21 patients the coronaries were imaged in plane with a 3D k-space segmented gradient echo sequence. A T2 preparation prepulse was used for suppression of myocardial signal, during free breathing and a navigator technique with using real time slice following and a gating window of 5 mm was applied to suppress breathing motion artefacts. Imaging was performed with standard gating and compared to 3D-MAG. Image quality was visually compared, contrast-to-noise and signal-to-noise ratio were calculated, the length of visualized coronary arteries was measured and scan duration and scan efficiency were calculated. Standard navigator imaging was feasible in 19 of 21 (90.5%) patients 3D-MAG in 21/21 (100%). Scan efficiency and duration was significantly improved with 3D-MAG (p < .05) without change in image quality. 3D-MAG is superior to conventional navigator correction algorithms. It improves feasibility and scan efficiency without reduction of image quality. This approach should be routinely used for MR coronary artery imaging with navigator techniques.

Algorithms↗

Determinants of myocardial response in CMR perfusion imaging using Gd-BOPTA (Multihance).

PURPOSE: Different centers and vendors use different sequences and contrast agent application schemes for MR myocardial perfusion imaging. The purpose of this study was to evaluate the role of different sequences, dosages, and injection speeds of contrast media for semiquantitative MR-perfusion assessment. METHODS: In a pilot study with 58 consecutive patients three of the most commonly used sequences for MR myocardial perfusion imaging (T1-GrE, GrE-EPI or SSFP) were compared to each other in terms of peak myocardial enhancement and image quality. For the main part of the study dynamic first pass MR perfusion imaging (Philips Intera CV, Best, Tthe Netherlands) was performed in 24 patients using the most favorable sequence from the pilot study (SSFP) after peripheral i.v. administration of Gd-BOPTA during adenosine stress. Two doses (0.05 mmol/kg bw and 0.025 mmol/kg bw) and four different injection speeds (8, 4, 3, 2 ml/s) were used. Signal intensity time curves were determined in the LV and myocardial segments supplied by normal coronary arteries and correlation between LV and myocardial upslope as well as peak enhancement were noted. RESULTS: The SSFP-sequence showed a higher peak enhancement when using 0.05 mmol/kg bw of Gd-BOPTA and a superior image quality for both dosage regimen compared with the other sequences and was consequently applied for the main study. A significant correlation was found between the upslopes in the LV and the myocardium (r square = 0.85, p < 0.001). However, LV and myocardial upslopes were largely independent of the dosage. Myocardial upslope was significantly slower at an injection rate of 2 ml/s compared to 3 and 4 ml/s. Higher Gd-doses led to significantly higher enhancement (p < 0.001). CONCLUSION: In healthy myocardial segments, the myocardial upslope is mainly determined from the LV upslope. Both myocardial enhancement and upslope are largely independent from the injection rate of a contrast agent bolus as long as the injection speed is not below 3 ml/s. Myocardial enhancement, however, is dose dependent. Thus, a simple correction for LV upslope allows to normalize a wide variety of input parameters. Differences of myocardial upslope or peak signal intensity after correction should be mainly dependent on blood flow.

Contrast Media↗

Cardiac magnetic resonance imaging: long term reproducibility of the late enhancement signal in patients with chronic coronary artery disease.

OBJECTIVE: To determine long term reproducibility of the late enhancement (LE) signal in contrast enhanced magnetic resonance imaging (MRI) and potential changes of the signal after revascularisation. METHODS: 33 patients (29 men, mean (SD) 61 (11) years) with coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 30 (7)%) underwent two contrast enhanced MRI procedures within 9 (3) months. Fifteen patients (group A: 14 men, 59 (12) years) had no interventions between the two studies. Eighteen patients underwent revascularisation after MRI 1 (group B: 15 men, 62 (9) years). Changes in the LE signal between the first and second MRIs were investigated in both groups as well as intraobserver and interobserver variabilities for delineation of the signal. RESULTS: The LE signal was highly reproducible in groups A and B for segmental analysis (concordance 86% v 82%, respectively; kappa = 0.70 v 0.67) and summed scores (group A: r = 0.97, p < 0.001; group B: r = 0.93, p < 0.001). The LE signal was quantified as 27 (27) cm3 in group A versus 30 (16) cm3 in group B in the first MRI and 26 (25) cm3 versus 30 (15) cm3, respectively, for the second MRI (both not significant). Moreover, low intraobserver and interobserver variabilities were observed in segmental analysis (kappa = 0.86 and 0.74, respectively, for group A, and kappa = 0.87 and 0.82, respectively, for group B). CONCLUSION: In patients with chronic CAD, the LE signal in contrast enhanced MRI is very stable over an extended time period. These results further characterise contrast enhanced MRI as a useful tool for myocardial viability assessment. Low intraobserver and interobserver variabilities promise robustness of the method for clinical application.

Aged↗

[MR-coronary angiography: comparison of SSFP and spoiled GRE sequence (bright blood technique) and a TSE sequence (black blood technique) in healthy volunteers].

PURPOSE: Comparison of a free breathing steady-state free precession (SSFP), a spoiled gradient-echo (GRE) and a turbo spin-echo sequence (TSE) for imaging of the coronary arteries (MRCA) in healthy volunteers. MATERIALS AND METHODS: Twenty-two healthy volunteers were imaged with a standard clinical scanner (1.5 T, Intera, Philips), with the right coronary system imaged in 11 and the left coronary system in the other 11 volunteers. Images were obtained with a 3D-SSFP (balanced TFE, TR 6.2 ms, TE 3.1 ms, alpha 65 degrees ), a 3D-GRE (TFE, TR 7.2 ms, TE 2.2 ms, alpha 30 degrees ) and a 2D-TSE (Dual-IR, TR 2RR, TE 25 ms) sequence. The in plane resolution was 0.7 x 0.8 mm for both the SSFP and GRE sequence with an effective slice thickness of 1.5 mm. For the TSE sequence, an in-plane resolution of 0.7 x 0.9 mm and a slice thickness of 3.0 mm were used. All investigations were performed using prospective navigator gating and slice-following technique. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the blood pool to myocardium and blood pool to epicardial fat were calculated. Image quality and measurement artifacts were assessed for all sequences by 5 independent investigators using a 4- and 5-point grading scale. RESULTS: CNR was significantly higher for the GRE sequence compared with the SSFP sequence and TSE sequence (mean 20.8 +/- 4.8 vs. 14.6 +/- 5.0 and 10.1 +/- 3.7 for blood pool to myocardium; mean 27.5 +/- 6.3 vs. 16.4 +/- 5.4 and 18.1 +/- 5.7 for blood pool to fat). The SNR revealed no significant differences between the SSFP and GRE sequences. The SSFP and the TSE sequences showed significantly more artefacts than the spoiled GRE sequence. Image quality was graded slightly higher for the GRE than for the SSFP sequence for the right coronary system, while there was no substantial difference in the left coronary system (median 2.1 +/- 0.6 and 2.5 +/- 0.6 vs. 2.5 +/- 0.8 and 2.6 +/- 0.7 for the right and left coronary system). In comparison, image quality was lower with the TSE sequence (median 2.9 +/- 0.5 for the right coronary system with p < 0.05 vs. GRE sequence and 3.0 +/- 0.3 for the left coronary system). CONCLUSION: For the scan parameters chosen in this study, the GRE-sequence represents the most robust technique for imaging of the coronary arteries. Currently, the TSE sequence is no alternative.

Adult↗

Improved functional cardiac MR imaging using the intravascular contrast agent CLARISCAN.

PURPOSE: Using segmented k-space turbo gradient echo MR techniques (TGE) contrast between blood and myocardium is often reduced in long axis views due to reduced in plane spin-refreshment, particularly in patients with low ejection fraction. The application of an intravascular contrast agent (CA) may improve endocardial border delineation. MATERIALS AND METHODS: In 15 patients cardiac cine loops in two long axis and two short axis views were acquired during breath hold using a TGE sequence without and with increasing doses of CA (0.75, 2.0, 5.0 mg Fe/kg). Two independent observers evaluated left ventricular function (LVEF, modified Simpson's rule) and assigned a visual score (range: 0 = 'not visualized' to 6 = 'excellent visualization') for endocardial border delineation. Signal- and contrast-to-noise ratios (SNR; CNR) were determined. RESULTS: Endocardial border delineation score for TGE was 1.7 +/- 0.6 and 3.9 +/- 0.6**, 4.4 +/- 0.5**, 4.6 +/- 0.4** for 0.75, 2.0, 5.0 mg Fe/kg of CA, respectively (**p < 0.01 vs. TGE). SNR of blood increased significantly with any dose of CA with a mild drop of myocardial SNR resulting in a significant increase of CNR blood/myocardium. The maximum effect with 2.0 mg Fe/kg was a >2-fold CNR increase. Inter- and intraobserver variability assessed according to the method of Bland-Altmann was reduced at 2.0 mg Fe/kg for determination of LVEF and reached statistical significance for LVEF <50%. CONCLUSION: Intravascular CA increased CNR between blood and myocardium by a factor >2 and significantly improved the determination of cardiac volumes. The benefit in accuracy was most for patients with left ventricular ejection fraction <50%.

Aged↗

Comparison of magnetic resonance real-time imaging of left ventricular function with conventional magnetic resonance imaging and echocardiography.

This study analyzes the accuracy of a new real-time magnetic resonance imaging (MRI) technique (acquisition duration, 62 ms/image) and echocardiography for the determination of left ventricular (LV) end-diastolic volume, end-systolic volume, ejection fraction, and muscle mass when compared with turbo gradient echo imaging as the reference standard. Thirty-four patients were examined with digital echocardiography, standard, and real-time MRI. A close correlation was found between the results of real-time imaging and the reference standard for end-diastolic volume, end-systolic volume, and ejection fraction (r >0.95), with a lower correlation for LV muscle mass (r = 0.81). Correlations between echocardiography and the reference standard were lower for all parameters. Real-time MRI enables the acquisition of high-quality cine loops of the entire heart in minimal time without electrocardiographic triggering or breath holding. Thus, patient setup and scan time can be reduced considerably. Results are similar to the reference standard and superior to echocardiography for determining LV volumes and ejection fraction. This technique is a valid alternative to current approaches and can form the basis of every cardiac MRI examination.

Adult↗

Multi-slice dynamic imaging: complete functional cardiac MR examination within 15 seconds.

A new magnetic resonance (MR) sequence was developed to acquire real-time images in a multi-slice dynamic imaging mode to cover the complete heart in 15 seconds without the need for electrocardiogram (ECG) triggering and multiple breath holds. In 34 patients, left ventricular function was assessed with the new technique and a standard technique. The new technique proved to be feasible and accurate for functional cardiac examinations.

Adult↗

Magnetic resonance flow measurements in real time: comparison with a standard gradient-echo technique.

Ultrafast gradient systems and hybrid imaging sequences offer the opportunity to acquire phase contrast flow data in real time. In a 1.5-Tesla magnetic resonance (MR)-tomograph, peak velocity and volume flow were assessed in 36 large vessels (aorta) and 33 medium-sized vessels (carotid and iliac artery) using a real-time (segmented k-space turbo gradient-echo planar imaging sequence) in comparison with a gradient-echo technique. With the real-time technique, the matrix was reduced from 116 to 64, and temporal resolution changed from 30 msec to 124 msec. Measurements of peak velocity correlated in large (r = 0.88) and medium-sized vessels (r = 0.81). Volume flow measurements correlated in large vessels (r = 0.87), however, a poor correlation (r = 0.64) was found in medium-sized vessels. Thus, scan time can be significantly reduced and images acquired without electrocardiogram (ECG)-triggering. Flow volume can only be determined in large vessels with sufficient accuracy, mainly due to reduced spatial resolution in smaller vessels.

Blood Flow Velocity↗

Functional cardiac MR imaging with steady-state free precession (SSFP) significantly improves endocardial border delineation without contrast agents.

Contrast between blood and myocardium in standard turbo gradient echo MR techniques (TFE) used routinely in clinical practice is mainly caused by unsaturated inflowing blood. Steady-state free precession (SSFP) has excellent contrast even in the absence of inflow effects. In 45 subjects cardiac cine loops in two long axis projections were acquired using TFE and compared with SSFP. A visual score (range 0 worst - 3 best) was assigned for endocardial border delineation for six myocardial segments in two long axis views. Endocardial border delineation score for TFE was 1.3 +/- 0.3 per segment and 2.4 +/- 0.3 for SSFP (P < 0.0001). Signal intensity blood/signal intensity myocardium was 1.5 +/- 0.4 at enddiastole and 1.4 +/- 0.3 at systole for TFE and 3.5 +/- 1.1 and 3.2 +/- 1.3 for SSFP, respectively (P < 0.0001). SSFP increases contrast between blood and myocardium more than twofold, resulting in an improved endocardial border definition. This may reduce variability for the determination of cardiac volumes and ejection fraction.

Adult↗

[Comparison of various parameters for determining an index of myocardial perfusion reserve in detecting coronary stenosis with cardiovascular magnetic resonance tomography].

For the assessment of myocardial perfusion with cardiac magnetic resonance imaging, different semiquantitative parameters of the first pass signal intensity time curves can be calculated and myocardial perfusion reserve indices can be determined. In this study we evaluated the feasibility of different perfusion parameters and their perfusion reserve indices for the detection of significant coronary artery stenosis. The signal intensity time curves of the first pass of a gadolinium-DTPA bolus injected via a central vein catheter before and after dipyridamole infusion were investigated in 15 patients with single vessel (stenosis > or = 75% area reduction) and five patients without significant coronary artery disease. For the distinction of ischemic and nonischemic myocardial segments, semiquantitative parameters, such as maximal signal intensity, contrast appearance time, time to maximal signal intensity and the steepness of the signal intensity curve's upslope determined by a linear fit, were assessed after correction for the input function. For each parameter a myocardial perfusion reserve index was calculated and cut off values for the detection of significant coronary stenosis were defined. The diagnostic accuracy of each parameter was then examined prospectively in 36 patients with coronary artery disease and compared with coronary angiography. Where as a distinction of ischemic and normal myocardium was possible with myocardial perfusion reserve indices, semiquantitative parameters at rest or after vasodilation alone did not allow such a distinction. The perfusion reserve index calculated from the upslope showed the most significant difference between ischemic and nonischemic myocardial segments (1.19 +/- 0.4 and 2.38 +/- 0.45, p < 0.001) followed by maximum signal intensity, time to maximum signal intensity and contrast apperance time. Sensitivity, specificity and diagnostic accuracy was 87, 82 and 85% for the detection of hypoperfusion induced by significant coronary artery stenoses using the perfusion reserve index calculated from the upslope. The steepness of the first pass signal intensity curve's upslope, determined by a linear fit, is a feasible parameter for the detection of significant coronary artery disease with MR. Based on a myocardial perfusion reserve index of this parameter, ischemic myocardium can be identified with high diagnostic accuracy.

Adult↗

Improvement of myocardial perfusion reserve early after coronary intervention: assessment with cardiac magnetic resonance imaging.

OBJECTIVES: The purpose of this study was to determine the potential value of magnetic resonance myocardial perfusion in the follow-up of patients after coronary intervention. BACKGROUND: In some patients a residual impairment of myocardial perfusion reserve (MPR) early after successful coronary intervention has been observed. In this study we evaluated an MPR index before and after intervention with magnetic resonance. METHODS: Thirty-five patients with single- and multivessel coronary artery disease were studied before and 24 h after intervention. The signal intensity time curves of the first pass of a gadolinium-diethylene triamine pentacetic acid bolus injected via a central vein catheter were evaluated before and after dipyridamole infusion. The upslope was determined using a linear fit. Myocardial perfusion reserve index was estimated from the alterations of the upslope. RESULTS: The MPR index in segments perfused by the stenotic artery was significantly lower than in the control segments (1.07 +/- 0.24 vs. 2.18 +/- 0.35, p < 0.001) and improved significantly after intervention (1.89 +/- 0.39, p < 0.001) but did not normalize completely (p < 0.01). After intervention the MPR index remained significantly lower in the balloon percutaneous transluminal coronary angioplasty group (1.72 +/- 0.38; n = 13) in comparison with the stent group (1.99 +/- 0.36, n = 18, p < 0.05). In the stent group a complete normalization of the MPR index was found 24 h after stenting. CONCLUSIONS: Magnetic resonance perfusion measurements allow a reliable assessment of MPR index. An improvement of MPR index can be observed after coronary intervention, which is more pronounced after stenting. Magnetic resonance perfusion measurements allow the assessment and may be useful for the follow-up of patients with coronary artery disease after coronary intervention.

Angioplasty, Balloon, Coronary↗

Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance.

BACKGROUND: Myocardial perfusion reserve can be noninvasively assessed with cardiovascular MR. In this study, the diagnostic accuracy of this technique for the detection of significant coronary artery stenosis was evaluated. METHODS AND RESULTS: In 15 patients with single-vessel coronary artery disease and 5 patients without significant coronary artery disease, the signal intensity-time curves of the first pass of a gadolinium-DTPA bolus injected through a central vein catheter were evaluated before and after dipyridamole infusion to validate the technique. A linear fit was used to determine the upslope, and a cutoff value for the differentiation between the myocardium supplied by stenotic and nonstenotic coronary arteries was defined. The diagnostic accuracy was then examined prospectively in 34 patients with coronary artery disease and was compared with coronary angiography. A significant difference in myocardial perfusion reserve between ischemic and normal myocardial segments (1.08+/-0.23 and 2.33+/-0.41; P<0.001) was found that resulted in a cutoff value of 1.5 (mean minus 2 SD of normal segments). In the prospective analysis, sensitivity, specificity, and diagnostic accuracy for the detection of coronary artery stenosis (> or =75%) were 90%, 83%, and 87%, respectively. Interobserver and intraobserver variabilities for the linear fit were low (r=0.96 and 0.99). CONCLUSIONS: MR first-pass perfusion measurements yielded a high diagnostic accuracy for the detection of coronary artery disease. Myocardial perfusion reserve can be easily and reproducibly determined by a linear fit of the upslope of the signal intensity-time curves.

Coronary Angiography↗

Coronary arterial stents: safety and artifacts during MR imaging.

PURPOSE: To investigate the safety and imaging artifacts with different coronary arterial stents and magnetic resonance (MR) imaging sequences. MATERIALS AND METHODS: The heating, artifacts, and ferromagnetism with different stents were studied with a 1.5-T MR tomograph with ultrafast gradients by using turbo spin-echo, turbo gradient-echo, and echo-planar imaging sequences. Nineteen stents, which were 8-25 mm in length and 3.0-4.5 mm in diameter, were evaluated. Stent deviation induced by the magnetic field and during MR imaging, migration, and heating caused by the radio-frequency pulses were examined. The size of imaging artifacts was measured with all the stents under standardized conditions and with six stents after their implantation into the coronary arteries of freshly explanted pig hearts. RESULTS: All except two types of stents showed minimal ferromagnetism. No device migration or heating was induced. Turbo spin-echo images had minimal artifacts; larger artifacts were seen on the turbo gradient-echo and echo-planar images. With ultrafast gradients, the artifacts on the echo-planar images were substantially reduced. CONCLUSION: The studied coronary stents were not influenced by heating or motion during 1.5-T MR imaging. Artifact size differed according to the type and size of the stent and the MR imaging sequence used. Thus, patients with these stents can be safely examined.

Angioplasty, Balloon, Coronary↗

Magnetic resonance real-time imaging for the evaluation of left ventricular function.

New ultrafast gradient systems and hybrid imaging sequences make it possible to acquire a complete image in real time, without the need for breathholding or electrocardiogram (ECG) triggering. In 21 patients, left ventricular function was assessed by the use of a turbo-gradient echo technique, an echo-planar imaging (EPI) technique, and a new real-time imaging technique. End-diastolic and end-systolic volumes, left ventricular muscle mass, and ejection fraction of the ultrafast techniques were compared with the turbo-gradient echo technique. Inter- and intraobserver variability was determined for each technique. Image quality was sufficient for automated contour detection in all but two patients in whom foldover occurred in the real-time images. Results of the ultrafast imaging techniques were comparable with conventional turbo-gradient echo techniques. There was a tendency to overestimate the end-diastolic volume by 3.9 and 1.3 ml with EPI real-time imaging, the end-systolic volume by 0.9 and 5.0 ml, and the left ventricular mass by 2.6 and 23.8 g. Ejection fraction showed a tendency to be overestimated by 1.1% with EPI and underestimated by 4.5% with real-time imaging. Correlation between EPI real-time imaging and turbo-gradient echo were 0.94 and O.95, respectively, for end-diastolic volumes, 0.98 and 0.96, respectively, for end-systolic volumes, and 0.96 and 0.89, respectively, for left ventricular mass. Inter- and intraobserver variability was low with all three techniques. Real-time imaging allows an accurate determination of left ventricular function without ECG triggering. Scan times can be reduced significantly with this new technique. Further studies will have to assess the value of real-time imaging for the detection of wall motion abnornmalities and the imaging of patients with atrial fibrillation.

Analysis of Variance↗

Noninvasive determination of coronary blood flow velocity with magnetic resonance imaging: comparison of breath-hold and navigator techniques with intravascular ultrasound.

The aim of this study was to evaluate two different magnetic resonance (MR) techniques for the noninvasive assessment of intracoronary blood flow. Coronary blood flow velocities were measured invasively in 26 angiographically normal segments of 12 patients. Noninvasive measurements were performed in identical segments with two MR techniques using a 1.5 T MR tomograph (ACS NT, Philips). A single breath-hold technique (temporal resolution: 140 msec) and a similar non-breath-hold technique with prospective navigator correction and improved temporal resolution (45 msec) were used. Maximal coronary flow velocities determined by MR correlated closely with invasive measurements (breath-hold: r = 0.70; navigator: r = 0.86); however, a significant underestimation of the MR measurements was found (slope = 0.33 and 0.37). The relative difference from the invasive method was lower for the navigator technique compared with the breath-hold technique (P<0.02). Both MR techniques allow the determination of coronary blood flow velocities. The higher temporal resolution and shorter acquisition window of navigator-corrected non-breath-hold techniques lead to increased accuracy. This approach is a further step toward the diagnostic use of MR flow measurements in coronary artery disease.

Aged↗

Optimization of realtime adaptive navigator correction for 3D magnetic resonance coronary angiography.

Breathing motion artifacts reduce the quality of MR coronary artery images. Real-time adaptive navigator correction with different correction factors (0%, 30%, 60%, 80% of diaphragmatic displacement) was used to correct for respiratory motion in 3D coronary artery imaging. Significant improvements of image quality were achieved by adaptive motion correction in comparison with conventional navigator gating. A close correlation between the correction factor, which yielded optimal image quality, and cardiac displacement relative to diaphragmatic displacement was found. The quality of coronary artery imaging can be improved using real-time adaptive navigator correction. Correction factors have to be adjusted for each segment of the coronary arteries and for each patient. Magn Reson Med 42:408-411, 1999.

Adult↗