Quantitative analysis of 1.5-T whole-heart coronary MR angiograms obtained with 32-channel cardiac coils: a comparison with conventional quantitative coronary angiography.

PURPOSE To develop a method to determine significant stenosis at whole-heart coronary magnetic resonance (MR) angiography and to evaluate the accuracy and reproducibility of this approach. MATERIALS AND METHODS The institutional review board approved the study, and all participants provided written informed consent. Sixty-two patients who were suspected of having coronary artery disease (CAD) and were scheduled for conventional coronary angiography were included. Coronary MR angiography was performed by using a 1.5-T imager with 32-channel coils. Luminal narrowing was evaluated with quantitative analysis (QA) of coronary MR angiograms on the basis of the signal intensity profile along the vessel. Percentage stenosis with QA of coronary MR angiograms was calculated as [1 - (SI(min)/SI(ref))] × 100, where SI(min) is minimal signal intensity and SI(ref) is corresponding reference signal intensity. Diagnostic performance of QA of coronary MR angiograms for predicting at least a 50% reduction in diameter was evaluated by using quantitative coronary angiography (QCA), with conventional angiography findings serving as the reference standard. Receiver operating characteristic (ROC) analysis, Spearman rank correlation, Bland-Altman analysis, and Cohen κ analysis were used. RESULTS The areas under the ROC curve in a segment-based analysis for detecting significant CAD were 0.96 (95% confidence interval [CI]: 0.94, 0.98) with QA of coronary MR angiograms and 0.93 (95% CI: 0.88, 0.98) with visual assessment. The correlation coefficients between percentage stenosis with QA of coronary MR angiograms and percentage stenosis with QCA were 0.84 (P < .001), 0.80 (P < .001), and 0.66 (P < .001) in the patient-, vessel-, and segment-based analyses, respectively. CONCLUSION QA of coronary MR angiograms with use of a signal intensity profile along the vessel permits detection of CAD. This method had a diagnostic performance approximately equal to that of visual analysis of coronary MR angiograms with high inter- and intraobserver reliability, allowing for more objective interpretation of coronary MR angiography findings.

[1]  E. Nagel,et al.  Impact of an abdominal belt on breathing patterns and scan efficiency in whole-heart coronary magnetic resonance angiography: comparison between the UK and Japan , 2011, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[2]  Masaaki Ito,et al.  Diagnostic accuracy of 1.5-T unenhanced whole-heart coronary MR angiography performed with 32-channel cardiac coils: initial single-center experience. , 2011, Radiology.

[3]  K. Katahira,et al.  Assessment of coronary artery disease using magnetic resonance coronary angiography: a national multicenter trial. , 2010, Journal of the American College of Cardiology.

[4]  Jouke Dijkstra,et al.  Automated quantification of stenosis severity on 64-slice CT: a comparison with quantitative coronary angiography. , 2010, JACC. Cardiovascular imaging.

[5]  N. Paul,et al.  Perioperative β-Blockers : Use With Caution Perioperative β Blockers in Patients Having Non-Cardiac Surgery : A Meta-Analysis , 2010 .

[6]  M. Budoff,et al.  Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Indi , 2008, Journal of the American College of Cardiology.

[7]  Debiao Li,et al.  Comparison of 3D free-breathing coronary MR angiography and 64-MDCT angiography for detection of coronary stenosis in patients with high calcium scores. , 2007, AJR. American journal of roentgenology.

[8]  Quantitative contrast enhanced magnetic resonance imaging for the evaluation of peripheral arterial disease: a comparative study versus standard digital angiography , 2007, The International Journal of Cardiovascular Imaging.

[9]  Kan Takeda,et al.  Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography. , 2006, Journal of the American College of Cardiology.

[10]  Kay Nehrke,et al.  Rapid and complete coronary arterial tree visualization with magnetic resonance imaging: feasibility and diagnostic performance. , 2005, European heart journal.

[11]  M. Van Cauteren,et al.  Assessment of coronary arteries with total study time of less than 30 minutes by using whole-heart coronary MR angiography. , 2005, Radiology.

[12]  G. Raff,et al.  Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. , 2005, Journal of the American College of Cardiology.

[13]  Konstantin Nikolaou,et al.  Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. , 2005, Journal of the American College of Cardiology.

[14]  René M. Botnar,et al.  Free-breathing 3D steady-state free precession coronary MR angiography with radial k-space sampling: comparison with cartesian k-space sampling and cartesian gradient-echo coronary MR angiography--pilot study. , 2004, Radiology.

[15]  Alastair J. Martin,et al.  Whole‐heart steady‐state free precession coronary artery magnetic resonance angiography , 2003, Magnetic resonance in medicine.

[16]  René M. Botnar,et al.  Coronary magnetic resonance angiography for the detection of coronary stenoses. , 2001, The New England journal of medicine.