Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0-T: a comparative study with X-ray angiography in a single center

J Am Coll Cardiol. 2009 Jun 30;54(1):69-76. doi: 10.1016/j.jacc.2009.03.016.

Abstract

Objectives: The purpose of this study was to prospectively evaluate the diagnostic performance of 3.0-T contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) in patients with suspected coronary artery disease (CAD).

Background: A slow-infusion, contrast-enhanced whole-heart CMRA approach has recently been developed at 3.0-T. The accuracy of this technique has not yet been determined among patients with suspected CAD.

Methods: The 3.0-T contrast-enhanced whole-heart CMRA was performed in 69 consecutive patients. An electrocardiography-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence was used to acquire isotropic whole-heart CMRA with slow infusion of 0.2 mmol/kg gadobenate dimeglumine. The diagnostic accuracy of whole-heart CMRA in detecting significant stenoses (> or =50%) was evaluated using X-ray angiography as the reference.

Results: The CMRA examinations were successfully completed in 62 patients. Acquisition time of whole-heart CMRA procedure was 9.0 +/- 1.9 min. The 3.0-T whole-heart CMRA correctly identified significant CAD in 32 patients and correctly ruled out CAD in 23 patients. The sensitivity, specificity, and accuracy of whole-heart CMRA for detecting significant stenoses were 91.6% (87 of 95), 83.1% (570 of 686), and 84.1% (657 of 781), respectively, on a per-segment basis. These values were 94.1% (32 of 34), 82.1% (23 of 28), and 88.7% (55 of 62), respectively, on a per-patient basis.

Conclusions: Contrast-enhanced whole-heart CMRA with 3.0-T allows for the accurate detection of coronary artery stenosis with high sensitivity and moderate specificity.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Contrast Media
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Meglumine / analogs & derivatives
  • Middle Aged
  • Organometallic Compounds
  • Prospective Studies

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobenic acid
  • Meglumine