Diagnostic role of contrast-enhanced whole-heart coronary magnetic resonance angiography in the evaluation of coronary artery disease
Li, Y.; Chen, B.; Guo, Y.; Lian, J.; Lin, Q.; Zhang, J.; Shi, D.; Xu, J.
Zhonghua Yi Xue Za Zhi 94(21): 1605-1608
2014
ISSN/ISBN: 0376-2491 PMID: 25152279 Document Number: 672626
To prospectively evaluate the diagnostic effectiveness of contrast-enhanced whole-heart coronary magnetic resonance angiography (CE-CMRA) in patients with suspected coronary artery disease (CAD) with conventional coronary angiography as the reference standard. A total of 72 subjects with suspected CAD scheduled for conventional coronary angiography underwent 3.0-T contrast-enhanced whole-heart CE-MRA. The imaging quality, diagnostic performance and accuracy of CE-MRA for detecting significant stenoses ( ≥ 50%) in coronary arteries were compared with that of quantitative coronary angiography (QCA). The whole-heart CE-MRA examinations were successfully completed in 65 patients. Among 809 segments with a reference luminal diameter ≥ 1.5 mm on CAG, 105 segments on CE-MRA were evaluated as nonassessable(13.0%) and 704 segments assessable.If 105 nonassessable segments on CE-MRA were considered to have significant stenoses, CE-MRA correctly identified CAD in 36/38 patients and correctly ruled out CAD in 21/27 patients. CE-MRA yielded 93.8%, 85.4%, 53.2% and 98.9% for diagnostic sensitivity, specificity, positive predicative value(PPV) and negative predicative value(NPV) on the basis of per-segment versus 94.7%, 77.8%, 85.7% and 91.3% respectively on the basis of per-patient. CE-CMRA provides sufficiently high sensitivity and NPV, but moderate specificity and PPV for the diagnosis of CAD.It may be used as an optional imaging modality for CAD screening.