Showing papers in "Journal of Magnetic Resonance Imaging in 1993"

“Keyhole” method for accelerating imaging of contrast agent uptake

Abstract: Magnetic resonance (MR) imaging methods with good spatial and contrast resolution are often too slow to follow the uptake of contrast agents with the desired temporal resolution. Imaging can be accelerated by skipping the acquisition of data normally taken with strong phase-encoding gradients, restricting acquisition to weak-gradient data only. If the usual procedure of substituting zeros for the missing data is followed, blurring results. Substitutinit instead reference data taken before or well after contrast agent injection reduces this problem. Volunteer and patient images obtained by using such reference data show that imaging can be us~eiklly accelerated severalfold. Cortical and medullary regions of interest and whole kidney regions were studied, and both gradientanld spin-echo images are shown. The method is believed to be coimpatible with other acceleration methods such as half-Fourier reconstruction and reading of mare than one line of k space per excitation.

Dynamic gadolinium‐enhanced three‐dimensional abdominal MR arteriography

Abstract: The abdominal aorta and renal, visceral, and iliac arteries were evaluated in 16 patients with three-dimensional Fourier transform imaging enhanced with gadopentetate dimeglumine. By imaging dynamically during the arterial phase of a 5-minute injection (0.2 mmol/kg), highly significant (P < .0001) preferential arterial enhancement (signal-to-noise ratio +/- standard deviation, 10 +/- 0.9), with minimal enhancement of the inferior vena cava (5.1 +/- 1.4) or background tissues (fat, 4.3 +/- 0.7; muscle, 2.4 +/- 0.5), was achieved in every patient. In six patients with angiographic and/or surgical correlation, 10 of 10 stenoses and two of two occlusions were correctly identified. No in-plane saturation or pulsatility artifact was identified in any of the 16 patients. In conclusion, dynamic imaging during the injection of gadopentetate dimeglumine is a promising technique for evaluation of the abdominal aorta and branch vessels.

Semiautomated method for noise reduction and background phase error correction in MR phase velocity data.

Abstract: Background phase distortion and random noise can adversely affect the quality of magnetic resonance (MR) phase velocity measurements. A semiauto-mated method has been developed that substantially reduces both effects. To remove the background phase distortion, the following steps were taken: The time standard deviations of the phase velocity images over a cardiac cycle were calculated. Static regions were identified as those in which the standard deviation was low. A flat surface representing an approximation to the background distortion was fitted to the static regions and subtracted from the phase velocity images to give corrected phase images. Random noise was removed by setting to zero those regions in which the standard deviation was high. The technique is demonstrated with a sample set of data in which the in-plane velocities have been measured in an imaging section showing the left ventricular outflow tract of a human left ventricle. The results are presented in vector and contour form, superimposed on the conventional MR angiographic images.

Accuracy of phase‐contrast flow measurements in the presence of partial‐volume effects

Abstract: The accuracy of volume flow rate measurements obtained with phase-contrast methods was assessed by means of computer simulation and in vitro experiments. Factors studied include (a) the partial-volume effect due to voxel dimensions relative to vessel dimensions and orientation and (b) intravoxel phase dispersion. It is shown that limited resolution (partial-volume effect) is the major obstacle to accurate flow measurement for both laminar and plug flow. The results show that at least 16 voxels must cover the cross section of the vessel lumen to obtain a measurement accuracy to within 10%. Measurement accuracy also greatly depends on the relative signal intensity of stationary tissue and is better for laminar flow than plug flow.

Basic physics of MR contrast agents and maximization of image contrast

Abstract: This review summarizes the physical basis of magnetic resonance (MR) imaging contrast agents, including both T1 agents, such as gadolinium-DTPA (diethylenetriaminepentaacetic acid), and T2 or T2* agents, such as superparamagnetic iron oxides. The maximization of image contrast and lesion visibility with contrast agents is described, and the use of contrast agents in MR angiography and perfusion imaging is discussed.

Biodistribution and toxicity of MR imaging contrast media.

Abstract: Keywords: Contrast enhancemen; ontrast media, toxicit; adolinium; Iron; Manganese; Safety

Discrimination between different types of white matter edema with diffusion-weighted MR imaging.

Abstract: Brain edema can be classified into three categories: vasogenic, cytotoxic, and interstitial. The mechanism of edema is thought to be different in each type. The authors studied the movement of water molecules in each type of white matter edema in a rat model by using diffusion-weighted magnetic resonance imaging. Conventional T2-weighted imaging did not allow distinction between the three types of white matter edema; the three types of edema were, however, distinguished by using diffusion-weighted imaging. The apparent diffusion coefficient (ADC) of water was different in each type of edema. Water molecules in cytotoxic edema induced by triethyl-tin intoxication showed a smaller and less anisotropic ADC than in normal white matter. In contrast, water in vasogenic edema induced by cold injury had a larger and more anisotropic ADC than in normal white matter. Water in interstitial edema due to kaolin-induced hydrocephalus had an anisotropic and very large ADC.

Flow velocity quantification in human coronary arteries with fast, breath‐hold MR angiography

Abstract: Measurement of coronary artery flow velocities has, until now, largely required the use of invasive technologies. The authors have implemented a breath-hold magnetic resonance (MR) angiography technique for depicting the coronary arteries and for quantifying flow velocities. The method was tested in flow phantoms and then applied to a series of subjects: 11 subjects were studied at rest, and four were studied before and during pharmacologic stress induced by intravenous adenosine. Flow velocities at rest in the midportion of the right coronary artery were 9.9 cm/sec +/- 3.5 (n = 12); in the proximal left anterior descending coronary artery, they were significantly higher, measuring 20.5 cm/sec +/- 5.2 (n = 6). With adenosine, flow velocities typically increased at least fourfold. The authors conclude that noninvasive measurement of coronary artery flow velocities is feasible with MR angiography; this method may prove useful for determining the physiologic significance of coronary artery stenosis.

Frequency dependence of MR relaxation times II. Iron oxides

Abstract: The frequency dependence of T1 and T2 was measured for homogeneous suspensions of magnetite and iron oxyhydroxide particles in water with various concentrations of gelatin. The transverse relaxivity showed two types of behavior: (a) For magnetic particles, there was a rapid increase in T2 relaxivity with frequency, followed by a saturation plateau, which accorded with the Langevin magnetization function. From these curves, the magnetic moment of the particle domains was estimated to range from 0.8 to 6.3 x 10(4) Bohr magnetons. (b) For iron oxyhydroxide (ferritin, ferrihydrite, and akaganeite) particles, T2 relaxivity increased linearly with frequency, the slope of the increase characteristic for each particle. T2 relaxivity generally increased with increasing gelatin concentration, corresponding to the measured decrease in the water diffusion coefficient. For iron oxides, homogeneously distributed either as iatrogenic agents or endogenous biominerals, these findings may aid in the interpretation of in vivo relaxivity and the effect on MR imaging.

Contrast-enhanced MR angiography

Abstract: Magnetic resonance (MR) angiography, although still in its infancy, is recognized as a valuable diagnostic tool. Investigation of the utility of contrast media as applied to MR angiography is, to no surprise, preliminary. In restricted instances, with present techniques, contrast media-enhanced MR angiography can provide additional valuable diagnostic information. Inspection of two-dimensional images (as opposed to three-dimensional projections) and comparison of MR images before and after administration of contrast agent are particularly important. Improved visualization of intracranial aneurysms, arteriovenous malformations, venous anomalies, and arterial occlusions has been demonstrated on three-dimensional time-of-flight MR angiograms after intravenous administration of a gadolinium chelate, relative to studies performed before administration of the contrast agent.

Implementation of wavelet-encoded MR imaging.

Abstract: Reconstructions of images from wavelet-encoded data are shown. The method of MR wavelet encoding in one dimension was proposed previously by Weaver and Healy. The technique relies on selective excitation with wavelet-shaped profiles generated by special radio-frequency waveforms. The result of the imaging sequence is a set of inner products of the image with orthogonal functions of the wavelet basis. Inversion of the wavelet data is accomplished with an efficient algorithm with processing times comparable with those of a fast Fourier transform. The experiments show that wavelet encoding by selective excitation of wavelet-shaped profiles is feasible. Wavelet-encoded images are compared with phase-encoded images that have a similar signal-to-noise ratio, and there is no discernible degradation in image quality due to the wavelet encoding. Potential benefits of wavelet encoding are briefly discussed.

Renal cancer staging: comparison of contrast-enhanced CT and gadolinium-enhanced fat-suppressed spin-echo and gradient-echo MR imaging

Abstract: Fifty-three consecutive patients with 61 solid or complex non-fat-containing renal masses compatible with renal cancer were examined with contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging with pre- and postcontrast FLASH (fast low-angle shot) and fat-suppressed spin-echo sequences. CT and MR imaging were performed within a 1-month interval. CT and MR images were prospectively interpreted. Tumor detection and staging were determined in all patients. CT and MR imaging enabled detection of 54 and 58 of 61 renal tumors, respectively. CT and MR imaging showed 34 and 35 of 38 histologically proved renal tumors, respectively, in 31 patients. Tumor size on CT and MR images demonstrated good correlation and correlated well with the size of pathologic specimens of 34 of 38 resected tumors detected with CT and MR imaging (r = .99). Of the 31 tumors in 31 patients who underwent surgical resection, 24 were correctly staged with CT and 29 with MR imaging. CT and MR imaging both enabled correct staging of four of five additional tumors with biopsy proof of tumor stage. A moderate difference in staging was observed between CT and MR imaging (P = .05). CT showed 13 and MR imaging 15 of 15 tumor thrombi. CT and MR imaging both showed 11 of 11 cases of adenopathy. The results suggest that MR imaging is moderately better than CT for the detection and staging of renal cancer.

Characterization of atherosclerosis with a 1.5-T imaging system.

Abstract: It is shown that a conventional 1.5-T magnetic resonance (MR) imaging system can help characterize some of the key components of atherosclerotic plaque ex vivo. Fresh human aorta with atheromata was suspended in solutions of agarose and manganese chloride and heated to body temperature. The specimens were imaged with modified Dixon and projection-reconstruction imaging sequences. The specimens were then examined histologically to obtain direct correlation between images, spectra, and histologic characteristics. The results show that vessel wall and plaque components can be identified by means of their MR characteristics and correlated with their histologic appearance. The authors were able to identify normal vessel wall components, such as adventitial lipids and smooth muscle. They were also able to identify and localize plaque components such as fibrous tissue, calcification, lipids, and possible areas of hemorrhage and hemosiderin deposition.

Proton relaxation enhancement

Abstract: Paramagnetic and superparamagnetic substances are used as contrast agents to enhance proton relaxation in magnetic resonance imaging. This review summarizes the physics of contrast agents, specifically the mechanisms by which contrast agents enhance T1 and T2 relaxation. The purpose is to provide a background for understanding the behavior of existing contrast agents in basic experimental and clinical studies. Terms such as magnetic dipole, dipole moment, magnetic susceptibility, diamagnetism, paramagnetism, superparamagnetism, and ferromagnetism are introduced. Two important interactions between the magnetic dipole moments of paramagnetic substances and the dipole moments associated with protons are described. The Solomon-Bloembergen-Morgan equations and other basic relaxation theory that has been confirmed experimentally are introduced to account for the dependence of relaxation on such parameters as the Larmor frequency, magnetic moment, accessibility of water molecules to the core of a contrast agent, and frequency of molecular motions.

Primary ovarian cancer : prospective comparison of contrast-enhanced CT and pre-and postcontrast, fat suppressed MR imaging, with histologic correlation

Abstract: Sixteen patients with clinically suspected malignant ovarian disease underwent contrast agent-enhanced computed tomography (CT) and magnetic resonance (MR) imaging in a prospective comparative study. MR imaging included fat-suppressed spin-echo and breath-hold FLASH (fast low-angle shot) before and after intravenous injection of gadopentetate dimeglumine. Histologic confirmation was obtained at laparotomy (n = 13) and biopsy (n = 3). Thirteen patients had histologically proven primary ovarian cancer. MR images showed the internal architecture of ovarian tumors better than CT in nine patients and equivalently in seven. MR images showed the relationship between ovarian tumors and adjacent pelvic structures (uterus [n = 9], sigmoid colon [n = 7], bladder [n = 7], and rectum [n = 3]) better than CT in nine patients and equivalently in seven. Intraabdominal extent of disease was better defined on MR than on CT images in nine patients, equivalently in six, and worse in one. Peritoneal metastases 1-2 cm in diameter were detected on MR images and missed on CT scans in six patients. In only one case did this result in a staging error with CT. The results suggest that MR imaging is at least equivalent and may be superior to CT in the evaluation of ovarian malignancy.

Applications of reduced-encoding MR imaging with generalized-series reconstruction (RIGR).

Abstract: The RIGR (reduced-encoding imaging by generalized-series reconstruction) technique for magnetic resonance imaging uses a high-resolution reference image as the basis set for the reconstruction of subsequent images acquired with a reduced number of phase-encoding steps. The technique allows increased temporal resolution in applications requiring repeated acquisitions, such as the dynamic imaging of contrast agent biodistribution, and in intrinsically time-consuming protocols such as the acquisition of a series of T2-weighted images. Several examples are presented to demonstrate that a four- to eightfold improvement in spatial or temporal resolution can be achieved with this technique.

Acute spinal ligament disruption: MR imaging with anatomic correlation

Abstract: Disruption of spinal ligaments can lead to instability that jeopardizes the spinal cord and nerve roots. Magnetic resonance (MR) imaging can directly image spinal ligaments; however, the sensitivity with which this modality demonstrates ligament injury has, to the authors' knowledge, not been reported. On a biomechanical testing machine, 28 cadaveric spines were subjected to controlled injury that resulted in ligament tears. The spines were then imaged with plain radiography, computed tomography, and MR imaging (1.5 T). The images were analyzed for evidence of ligament injury before dissection of the specimen. Forty-one of 52 (79%) ligament tears of various types were correctly identified at MR imaging. Disruptions of the anterior and posterior longitudinal ligaments were most conspicuous and were detected in all seven cases in which they were present (no false-positive or false-negative results); disruptions of the ligamentum flavum, capsular ligaments, and interspinous ligaments could also be identified but less reliably (three false-positive and 11 false-negative results). That MR imaging can reliably and directly allow assessment of spinal ligament disruption in this in vitro model suggests its potential utility for this assessment in patients.

Quantitative analysis of gadopentetate dimeglumine excreted in breast milk.

Abstract: Specimens of breast milk were obtained from each breast in a lactating patient for a 24-hour period after a gadolinium-enhanced MR imaging examination was performed. A quantitative analysis of gadolinium content in specimens obtained at 2, 11, 17, and 24 hours after the intravenous administration of gadopentetate dimeglumine demonstrated that gadolinium is excreted in small amounts (total of 1.60 mumol during a 24-hour period) and in similar amounts from each breast. These results suggest that a waiting period of 24 hours, with active expression of breast milk from each breast, should provide a reasonable safety margin for allowing resumption of breast-feeding. Additional data will be required before establishing definitive recommendations.

MR monitoring during cryotherapy in the liver: Predictability of histologic outcome

Abstract: For well-controlled application of cryotherapy to focal liver lesions, real-time monitoring is necessary to limit the final necrotic effect in the treated area. In this study, near real-time magnetic resonance (MR) monitoring images of normal rabbit liver were obtained during the freezing procedure. The MR-monitored, freezing-induced lesions were followed with MR images for up to 3 weeks. Corresponding histologic samples were also obtained over the same time period. Our results indicate that MR images obtained during the freezing procedure can adequately depict the area of final necrosis. Furthermore, histologic changes at each stage of lesion development correlated well with MR signal intensities on follow-up images. With the development of an MR-compatible cryogen probe, MR imaging may prove to be a robust method for monitoring, controlling, and following up cryotherapy in the liver.

Three-dimensional MR imaging of the coronary arteries: preliminary clinical experience.

Abstract: A three-dimensional (3D) magnetization-prepared (MP) rapid gradient-echo (RAGE) and 3D RAGE technique was used to image the coronary arteries in healthy volunteers and patients with known disease. Each sequence produced images of volumes partitioned into 16 thin sections with differing blood-fat-myocardium contrast. The two types of images were subtracted to null fat signal, thus producing a third image set that showed flowing blood. Total imaging time was about 17 minutes. In the volunteers, the 3D MP-RAGE and subtraction images consistently showed the morphology of the right coronary artery. The left main and left anterior descending arteries were also well seen. The circumflex artery was less consistently identified. Of the 17 diseased coronary artery segments identified at catheterization, 16 had altered signal intensity (narrowing, occlusion, reduced contrast-to-noise ratio, irregularity) on the subtraction images, while 13 had altered signal intensity on the 3D MP-RAGE images. The results indicate that this 3D MP-RAGE and 3D RAGE technique has potential utility as a screening method for coronary heart disease.

MR imaging of the breast.

Abstract: The current strategy for breast cancer treatment involves early detection of the neoplasm before it has metasta-sized outside the breast, and surgical treatment of the lesion that minimizes deformity. Conventional methods of diagnostic imaging of the breast, including mammogra-phy, sonography, and galactography, do not adequately address clinical needs with regard to lesion characterization and staging. Magnetic resonance (MR) imaging has been proposed as a modality that may address these needs. The potential clinical uses of MR imaging are defined in terms of clinical needs and technologic requirements. Applications of MR imaging in detection of breast lesions can be divided into two major approaches based on the clinical questions to be answered: (a) improved specificity and (b) improved sensitivity. These approaches are defined by specific sets of clinical needs and have substantially different technologic requirements. The specificity approach is used to reduce the number of biopsies performed to confirm false-positive mammo-graphic findings. The MR imaging device that is used to improve specificity must visualize only the lesions that are seen mammographically. The sensitivity approach requires the visualization of lesions not identified at mammography, so that breast disease can be more effectively staged for treatment. The technologic requirements for the sensitivity approach are considerably more rigorous, because all lesions must be identified. The advantages and disadvantages of each of these approaches and the potential clinical ramifications are described.

Chronic pancreatitis: MR imaging features before and after administration of gadopentetate dimeglumine

Abstract: Magnetic resonance (MR) imaging was performed in patients with a history (> 1 year) of inflammatory pancreatic disease. Calcification was seen at recent computed tomographic examinations in 13 patients and was not seen in nine patients. On fat-suppressed spin-echo images, the signal-to-noise ratio of the pancreas was significantly lower (P < .001) in patients with pancreatic calcification (18.2 +/- 2.5 vs 38.1 +/- 6.1). On fast low-angle shot images, the percentage of contrast enhancement was also significantly lower (P < .001) in patients with calcification (26.1% +/- 5.8 vs 78.7% +/- 15.9). The results suggest that MR imaging may be useful in evaluating patients with a long history of pancreatic disease for the presence of irreversible disease.

Pulsed magnetization transfer spin-echo MR imaging

Abstract: Cross relaxation between macromolecular protons and water protons is known to be important in biologic tissue. In magnetic resonance (MR) imaging sequences, selective saturation of the characteristically short T2 macromolecular proton pool can produce contrast called magnetization transfer contrast, based on the cross-relaxation process. Selective saturation can be achieved with continuous wave irradiation several kilohertz off resonance or short, intense 0 degree pulses on resonance. The authors analyze 0 degree binomial pulses for T2 selective saturation, present design guidelines, and demonstrate the use of these pulses in spin-echo imaging sequences in healthy volunteers and patients. Using the phenomenologic Bloch equations modified for two-site exchange, the authors derive the analytic expressions for water proton relaxation under periodic pulsed saturation of the macromolecular protons. This relaxation is shown to be monoexponential, with a rate constant dependent on the saturation pulse repetition rate and the individual and cross-relaxation rates.

Brodie Abscess: MR imaging appearance in 10 patients

Abstract: The magnetic resonance (MR) imaging features of Brodie abscess have not yet been fully evaluated. Ten patients with Brodie abscess, eight of long bone and two of vertebra, were studied with MR imaging. Long bone abscess had a characteristic “target” appearance with four layers: (a) a center with low signal intensity on T1-weighted images and high signal intensity on T2-weighted and STIR (short-inversion-time inversion recovery) images, (b) an inner ring isointense to muscle on T1-weighted images and with high signal intensity on T2-weighted and STIR images, (c) an outer ring hypoin-tense on all images, and (d) a peripheral halo hypointense on T1-weighted images. In six of eight cases, a soft-tissue mass was found. The two vertebral abscesses had a less specific appearance, with low signal intensity on T1-weighted images and high signal intensity on T2-weighted and STIR images. Only the peripheral halo was clearly identified in both cases.

Functional mapping of human motor cortical activation with conventional MR imaging at 1.5 T.

Abstract: A conventional 1.5-T magnetic resonance (MR) imager was used to detect signal intensity changes on T2*-weighted images of human motor and sensory cortices during performance of hand and tongue movements. Narrow receiver bandwidths were used to improve the signal-to-noise ratio. Protocols consisting of baseline, motor task, rest, and second motor task periods were performed by nine volunteers. Two-dimensional cross correlation was applied to correct in-plane translation and rotation of the head during the imaging session before the control images were subtracted from the task images. Measurements obtained during finger movement tasks indicated a 3%-8% increase in signal intensity near the contralateral central sulcus and smaller ipsilateral signal intensity increases. Bilateral signal intensity increases were also observed during tongue movement studies. A retrospective image registration technique was used to map the signal changes onto conventional anatomic images, which were used to create integrated three-dimensional models of brain structure and function. These integrated images showed that the highest signal intensity due to hand movement was near the putative central sulcus.

Accuracy and precision of MR velocity mapping in measurement of stenotic cross-sectional area, flow rate, and pressure gradient

Abstract: Reliability of magnetic resonance (MR) velocity mapping to assess severity of stenosis was assessed in vitro. Steady flow at different flow rates through five stenoses with a central orifice area ranging from 17 to 176 mm2 was measured with velocity mapping performed perpendicular to the stenotic jet. Besides determination of the stenotic cross-sectional area and flow rate, the pressure gradient was calculated with the modified Bernoulli equation and compared with manometer measurements. Cross-sectional areas were measured with an accuracy of > or = 76%, a precision of > or = 91%, and an error of or = 72%, a precision of > or = 94%, and an error of or = 80%, a precision of > or = 88%, and an error of < or = 15 mm Hg. The method was applied in a single patient with aortic stenosis and gave estimates that agreed with those obtained by heart catheterization.

Uterine contractions: possible diagnostic pitfall at MR imaging.

Abstract: A total of 206 nongravid patients with various gynecologic problems underwent pelvic magnetic resonance (MR) examinations that included both sagittal T2-weighted and contrast agent-enhanced T1-weighted images. MR images were retrospectively reviewed to identify changes in endometrial configuration on serial images obtained during the same MR examination. In 20 MR examinations (all in women of reproductive age), endometrial distortion due to myometrial bulging was noted on T2-weighted or contrast-enhanced T1-weighted images. It was absent on other MR images obtained at different times. Myometrial bulging exhibited low signal intensity in 18 examinations. The finding resembled adenomyosis or leiomyoma on T2-weighted or contrast-enhanced T1-weighted images. These results evidence the presence of transient myometrial bulging and transient low-intensity myometrium in the nongravid uterus. This phenomenon is thought to represent uterine contraction. Clinicians should be aware of the potential presence of transient low-signal-intensity myometrial bulging that could present diagnostic problems in the normal uterus.

Reduction of ringing and blurring artifacts in fast spin‐echo imaging

Abstract: A simple method was devised to reduce ringing and blurring artifacts caused by discontinuous T2 weighting of k-space data in fast spin-echo magnetic resonance (MR) imaging. The method demodulates the weighting function along the phase-encoding direction by using multiple T2 values derived from a set of non-phase-encoded echoes obtained from an extra excitation. The performance of this method was evaluated by computer simulations and experiments, which confirmed its capability of effectively reducing or, in some cases, even completely removing the ringing and blurring artifacts. The results also show that the proposed method produces better results than other artifact reduction methods. The method is particularly useful at high magnetic field strengths (7.1-9.4 T) and with strong gradients (> 20 G/cm) used in MR microscopy, in which the apparent T2 values are short for most tissues. The authors expect that the proposed method will find useful applications in various fast spin-echo pulse sequences.

MR characterization of blood flow in native and grafted internal mammary arteries.

Abstract: In the postoperative patient with anginal symptoms, differentiation between bypass graft compromise and nonischemic causes has until now been accomplished only by means of x-ray angiography. A non-invasive test is clearly desirable. The authors used a cine phase-contrast (PC) magnetic resonance (MR) imaging technique to characterize blood flow in native and grafted internal mammary arteries (IMAs). Ten volunteers and 15 patients who had recently undergone IMA coronary artery bypass grafting were imaged. Cine PC MR imaging was performed in the transaxial plane at the level of the pulmonary artery bifurcation. Flow in both IMAs was quantified and expressed as a percentage of cardiac output measured in the ascending aorta. In the 15 patients, flow analysis was performed in both the native and grafted IMAs. In the volunteers, IMA blood flow ranged from 2.1% to 4.3% of cardiac output on the left (mean, 3.5%) and 2.1% to 5.1% (mean, 3.5%) on the right. There was considerable intersubject variability, with coefficients of variation of 10.7% for the left and 12.3% for the right IMA. Intrasubject variability was limited, with estimated common standard deviations of 0.45% of cardiac output (range, 0.2%-1.1%) for the left and 0.39% (range, 0.1%-0.6%) for the right IMA. Flow in grafted IMAs was identified in 13 of 15 patients. In one of two patients without demonstrable IMA graft flow, cardiac catheterization confirmed lack of flow. IMA graft flow varied from 28 to 164 mL/min (mean, 80.3 mL/min). This study shows the feasibility of using cine PC MR imaging as a quantitative method of evaluating blood flow in IMA coronary artery bypass grafts.