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
Auerbachstraße 110
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Phone: 0711/81013456
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Email: udo.sechtem@rbk.de
