• Aurélien Bustin, Giulia Ginami, Gastão Cruz, Teresa Correia, Tevfik F Ismail, Imran Rashid, Radhouene Neji, René M Botnar, and Claudia Prieto.
• School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.
• Magn Reson Med. 2019 Jan 1; 81 (1): 102-115.

PurposeTo enable whole-heart 3D coronary magnetic resonance angiography (CMRA) with isotropic sub-millimeter resolution in a clinically feasible scan time by combining respiratory motion correction with highly accelerated variable density sampling in concert with a novel 3D patch-based undersampled reconstruction (3D-PROST).MethodsAn undersampled variable density spiral-like Cartesian trajectory was combined with 2D image-based navigators to achieve 100% respiratory efficiency and predictable scan time. 3D-PROST reconstruction integrates structural information from 3D patch neighborhoods through sparse representation, thereby exploiting the redundancy of the 3D anatomy of the coronary arteries in an efficient low-rank formulation. The proposed framework was evaluated in a static resolution phantom and in 10 healthy subjects with isotropic resolutions of 1.2 mm3 and 0.9 mm3 and undersampling factors of ×5 and ×9. 3D-PROST was compared against fully sampled (1.2 mm3 only), conventional parallel imaging, and compressed sensing reconstructions.ResultsPhantom and in vivo (1.2 mm3 ) reconstructions were in excellent agreement with the reference fully sampled image. In vivo average acquisition times (min:s) were 7:57 ± 1:18 (×5) and 4:35 ± 0:44 (×9) for 0.9 mm3 resolution. Sub-millimeter 3D-PROST resulted in excellent depiction of the left and right coronary arteries including small branch vessels, leading to further improvements in vessel sharpness and visible vessel length in comparison with conventional reconstruction techniques. Image quality rated by 2 experts demonstrated that 3D-PROST provides good image quality and is robust even at high acceleration factors.ConclusionThe proposed approach enables free-breathing whole-heart 3D CMRA with isotropic sub-millimeter resolution in <5 min and achieves improved coronary artery visualization in a short and predictable scan time.© 2018 International Society for Magnetic Resonance in Medicine.

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