Clinical comparison of sub-mm high-resolution non-contrast coronary CMR angiography against coronary CT angiography in patients with low-intermediate risk of coronary artery disease: a single center trial

Journal of Cardiovascular Magnetic Resonance

Rebecca Preston¹  Camila Munoz²  Gastao Cruz²  Amedeo Chiribiri²  Reza Hajhosseiny²  Reza Razavi²  Imran Rashid²  Aurélien Bustin²  Pier Giorgio Masci²  Tevfik F. Ismail³  Muhummad Sohaib Nazir³  Karine Grigoryan³  Ronak Rajani³  René M. Botnar⁴  Claudia Prieto⁴  Karl Kunze⁵  Radhouene Neji⁵ 

[1] Department of Radiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK;School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rdfloor Lambeth Wing, SE1 7EH, London, UK;School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rdfloor Lambeth Wing, SE1 7EH, London, UK;Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK;School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rdfloor Lambeth Wing, SE1 7EH, London, UK;Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile;School of Biomedical Engineering and Imaging Sciences, King’s College London, 3rdfloor Lambeth Wing, SE1 7EH, London, UK;MR Research Collaborations, Siemens Healthcare Limited, Frimley, UK;

关键词: Coronary artery disease;    Coronary magnetic resonance angiography;    CMRA;    Atherosclerosis;    High resolution;    Coronary angiography;   

DOI  :  10.1186/s12968-021-00758-9

来源: Springer

【 摘 要 】

BackgroundThe widespread clinical application of coronary cardiovascular magnetic resonance (CMR) angiography (CMRA) for the assessment of coronary artery disease (CAD) remains limited due to low scan efficiency leading to prolonged and unpredictable acquisition times; low spatial-resolution; and residual respiratory motion artefacts resulting in limited image quality. To overcome these limitations, we have integrated highly undersampled acquisitions with image-based navigators and non-rigid motion correction to enable high resolution (sub-1 mm3) free-breathing, contrast-free 3D whole-heart coronary CMRA with 100% respiratory scan efficiency in a clinically feasible and predictable acquisition time.ObjectivesTo evaluate the diagnostic performance of this coronary CMRA framework against coronary computed tomography angiography (CTA) in patients with suspected CAD.MethodsConsecutive patients (n = 50) with suspected CAD were examined on a 1.5T CMR scanner. We compared the diagnostic accuracy of coronary CMRA against coronary CTA for detecting a ≥ 50% reduction in luminal diameter.ResultsThe 50 recruited patients (55 ± 9 years, 33 male) completed coronary CMRA in 10.7 ± 1.4 min. Twelve (24%) had significant CAD on coronary CTA. Coronary CMRA obtained diagnostic image quality in 95% of all, 97% of proximal, 97% of middle and 90% of distal coronary segments. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were: per patient (100%, 74%, 55%, 100% and 80%), per vessel (81%, 88%, 46%, 97% and 88%) and per segment (76%, 95%, 44%, 99% and 94%) respectively.ConclusionsThe high diagnostic image quality and diagnostic performance of coronary CMRA compared against coronary CTA demonstrates the potential of coronary CMRA as a robust and safe non-invasive alternative for excluding significant disease in patients at low-intermediate risk of CAD.

【 授权许可】

CC BY