Additive value of 3T cardiovascular magnetic resonance coronary angiography for detecting coronary artery disease

Journal of Cardiovascular Magnetic Resonance

Debiao Li¹  Xiantao Song²  Jianan Li²  Lijun Zhang³  Zhanming Fan³  Ruiyu Dou³  Li Dong³  Jing An⁴ 

[1] Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, University of California;Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University;Department of Radiology, Beijing Anzhen Hospital, Capital Medical University;Siemens Shenzhen Magnetic Resonance Ltd;

关键词: 3 Tesla;    Contrast enhanced;    Coronary magnetic resonance angiography;    Stress-rest perfusion imaging;    Late gadolinium enhancement;    Coronary artery disease;   

DOI  :  10.1186/s12968-018-0450-2

来源: DOAJ

【 摘 要 】

Abstract Background The purpose of the work was to evaluate the incremental diagnostic value of free-breathing, contrast-enhanced, whole-heart, 3 T cardiovascular magnetic resonance coronary angiography (CE-MRCA) to stress/rest myocardial perfusion imaging (MPI) and late gadolinium enhancement (LGE) imaging for detecting coronary artery disease (CAD). Methods Fifty-one patients with suspected CAD underwent a comprehensive cardiovascular magnetic resonance (CMR) examination (CE-MRCA, MPI, and LGE). The additive diagnostic value of MRCA to MPI and LGE was evaluated using invasive x-ray coronary angiography (XA) as the standard for defining functionally significant CAD (≥ 50% stenosis in vessels > 2 mm in diameter). Results 90.2% (46/51) patients (54.0 ± 11.5 years; 71.7% men) completed CE-MRCA successfully. On per-patient basis, compared to MPI/LGE alone or MPI alone, the addition of MRCA resulted in higher sensitivity (100% vs. 76.5%, p < 0.01), no change in specificity (58.3% vs. 66.7%, p = 0.6), and higher accuracy (89.1% vs 73.9%, p < 0.01) for CAD detection (prevalence = 73.9%). Compared to LGE alone, the addition of CE-MRCA resulted in higher sensitivity (97.1% vs. 41.2%, p < 0.01), inferior specificity (83.3% vs. 91.7%, p = 0.02), and higher diagnostic accuracy (93.5% vs. 54.3%, p < 0.01). Conclusion The inclusion of successful free-breathing, whole-heart, 3 T CE-MRCA significantly improved the sensitivity and diagnostic accuracy as compared to MPI and LGE alone for CAD detection.

【 授权许可】

Unknown