(MRI-CA, MRCA) The noninvasive imaging of the coronary arteries using magnetic resonance imaging of the heart.
For cardiac MRI-CA, high performance machines are necessary with minimum 40mT/m and 300μsec slew rate.
2D and 3D acquisition are used for fast gradient echo sequences with techniques for minimizing cardiac and respiratory motion and suppressing the high signal of pericardial fat. The optimal sequences seem to be trueFISP, Balanced FFE or FIESTA with SMASH and SENSE techniques. Respiratory motion is minimized for 3D acquisitions by using respiratory gating, especially using navigator echoes (Navigator Technique) to track diaphragmatic and cardiac movement. Optimization of MR technique can provide mapping of long segments of the coronary arteries.
Blood pool agents are being applied to improve the reliability of coronary MR angiography. The major current clinical indication is the identification of coronary artery anomalies because the diagnostic accuracy's for identifying haemodynamically significant stenoses are variable depending of the image quality.

See also Magnetic Resonance Angiography, and Cardiac MRI.

MS-325 is the formerly code name of gadofosveset trisodium (new trade name Vasovist). MS-325 belongs to a new class of blood pool agents for magnetic resonance angiography (MRA) to diagnose vascular disease. Gadofosveset trisodium has ten times the signal-enhancing power of existing contrast agents as well as prolonged retention in the blood. This enables the rapid acquisition of high resolution MRA's using standard MRI machines.
Gadofosveset trisodium, which is gadolinium-based, stays in the blood stream as a result of transient binding to albumin. Albumin binding offers an additional benefit beyond localization in the blood pool. The contrast agent begins to spin much more slowly, at the rate albumin spins, causing a relaxivity gain that produces a substantially brighter signal than would be possible with freely circulating gadolinium. MS-325 is an intravascular contrast agent intended for use in MRI as an aid in diagnosing aortoiliac occlusive disease in patients with known or suspected peripheral vascular disease (PVD) or abdominal aortic aneurysm (AAA).
Currently clinical trials completed for peripheral vascular disease and coronary artery disease. Additional trials are also being conducted to evaluate MS-325 as an aid in diagnosing breast cancer and suggested that it might be feasible to combine the use of MS-325, injected during peak stress, with delayed high-resolution imaging to identify myocardial perfusion defects.
Vasovist (MS-325) would compete with the contrast agents Ferumoxytol (Code 7228) from AMAG Pharmaceuticals, Inc. and NC100150 Injection from Nycomed Amersham, but their further development is uncertain.
Partners in development: EPIX Pharmaceuticals, Inc., Mallinckrodt Inc., and Bayer Schering Pharma AG. Bayer Schering Pharma has the worldwide marketing rights for the product.
Formerly known under the Mallinckrodt trademark name, AngioMARK®.

See also Classifications, Characteristics, etc.

Short name: B22956, generic name: Gadocoletic acid, chemical compound: Gadocoletic acid trisodium salt, central moiety: Gd, phase: II
A blood pool agent for magnetic resonance coronary angiography and first pass myocardial perfusion imaging under development (Bracco Diagnostics Inc). The small molecules of gadolinium-based B22956 are bound after injection to large human serum albumin molecules in coronary vessels with the result of high vessel/muscle contrast.

Vasovist™ is an albumin-targeted intravascular contrast agent. It is indicated for contrast enhanced MR angiography (CE-MRA) for the visualization of abdominal or limb vessels in patients with suspected or known vascular disease. After IV injection, Vasovist™ binds reversibly to human albumin in plasma, which results in long-lasting increased relaxivity. Imaging from 5 to 50 min is possible. A small unbound portion is, by glomerular filtration, eliminated by the kidneys.
AngioMARK® was the formerly trade name and MS-325 the research name. Currently the phase III clinical trials are completed to determine its efficacy for peripheral vascular disease and coronary artery disease.
In the U.S., EPIX received an approvable letter from the U.S. Food and Drug Administration (FDA) for Vasovist™ in January 2005. In 2009, Epix Pharmaceuticals has sold the U.S., Canadian and Australian rights for its blood pool agent (now named ABLAVAR™), to Lantheus Medical Imaging, Inc..

WARNING: NEPHROGENIC SYSTEMIC FIBROSIS Gadolinium-based contrast agents increase the risk for nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency (glomerular filtration rate less than 30 mL/min/1.73m²), or acute renal insufficiency of any severity due to the hepato-renal syndrome or the liver transplantation period.

See also MRI Safety.