Magnetic Resonance Angiography to Diagnose Atherosclerotic Disease

Exclusion Criteria

• •1. Subjects with contraindication to MRI scanning. These contraindications include but are not limited to the following devices or conditions:
• •1. Implanted cardiac pacemaker or defibrillator
• •2. Cochlear Implants
• •3. Ocular foreign body (e.g. metal shavings)
• •4. Embedded shrapnel fragments
• •5. Central nervous system aneurysm clips
• •6. Implanted neural stimulator
• •7. Medical infusion pumps
• •8. Any implanted device that is incompatible with MRI.
• •2. Unsatisfactory performance status as judged by the referring physician such that the subject could not tolerate an MRI scan. Examples of medical conditions that would not be accepted would include unstable angina and dyspnea at rest.
• •3. Subjects requiring sedation for MRI studies.
• •4. Subjects with a condition precluding entry into the scanner (e.g. morbid obesity, claustrophobia, etc.).
• •5. Pregnant or lactating women.
• •6. Subjects with severe back-pain or motion disorders who will be unable to tolerate supine positioning within the MRI scanner and hold still for the duration of the examination.
• •7. Subjects who are unable to undergo a CTA within 1 month of the MRA part of this study, or are unable undergo or be scheduled for a cardiac catheterization within 1 month of the MRA.
• •FOR GADOLINIUM BASED MRI STUDIES ONLY:
• •8. History of severe allergic reaction to gadolinium contrast agents despite the use of premeditation with an anti-histaminic and cortisone.
• •9. Creatinine value greater than 3.0 mg/dl
• •FOR CARDIAC CT:
• •10. Recent cardiac CT within a month. Both a coronary CTA and calcium score scan are required for this study. If any of these scans were performed at an outside facility and meet the necessary quality level, then that aspect of the cardiac CT scan (coronary CTA, calcium score scan or both) will not be performed at the NIH. Coronary CTA and/or calcium score CT obtained at the outside facility must be performed within one month of subject inclusion and acquired using a 16 slice scanner or higher and should be of good quality. The unformatted images of outside cardiac scans must be available to the primary investigator within one month of their acquisition for eligibility of inclusion in the study.
• •FOR CORONARY CTA:
• •11. Contraindication to the use of CT contrast agents:
• •1. Creatinine value greater than 1.4 mg/dl
• •2. History of multiple myeloma
• •3. Use of metformin-containing products less than 24 hrs prior to contrast administration
• •4. History of significant allergic reaction to CT contrast agents despite the use of premeditation with an anti-histaminic and cortisone.
• •12. Subjects with contraindication precluding the use of beta blockers necessary to perform the coronary CTA. These include:
• •1. Asthma
• •2. Active bronchospasm
• •3. Moderate or severe COPD
• •4. Second or third degree AV block
• •5. Decompensated cardiac failure
• •6. Allergy to beta blockers
• •7. Systolic blood pressure less than 100 mm Hg
• •8. Pregnancy or nursing