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Three-dimensional, Navigator-Echo MR Coronary Angiography in Detecting Stenoses of the Major Epicardial Vessels, with Conventional Coronary Angiography as the Standard of Reference¹

¹ From the Departments of Radiology (F.S., F.Z.) and Cardiology (G.M., M.B.), University of Genoa School of Medicine, Largo R Benzi 10, Genoa I-16132, Italy. From the 1997 RSNA scientific assembly. Received September 9, 1998; revision requested October 26; final revision received June 25, 1999; accepted July 22. Address reprint requests to F.S., Department of Diagnostic Imaging, the Biomedical Institute, Via Prà 1/b, I-16157, Genoa, Italy (e-mail: sardanelli@biomedical.www-it.com).

PURPOSE: To test three-dimensional (3D), navigator-echo magnetic resonance (MR) coronary angiography in detecting stenoses of the coronary arteries.

MATERIALS AND METHODS: Forty-two patients (age range, 50–79 years) underwent MR coronary angiography (1.5 T). A navigator-echo sequence was used. Two or three 15% overlapped transverse slabs were acquired. Data were analyzed by readers blinded to conventional coronary angiographic results. On conventional coronary angiograms, coronary arterial stenoses of 50% or greater narrowing were considered significant. On MR coronary angiograms, the major coronary vessels were subdivided into proximal (within 5 cm) and distal (beyond 5 cm) segments, except for the left main vessel. Stenoses of 50% or greater were identified on reformatted multiplanar MR coronary angiograms.

RESULTS: Three MR coronary angiographic examinations were aborted because of patient claustrophobia; 39 of 39 left main, 117 of 117 proximal, and 78 of 117 distal segments were visualized. MR coronary angiography showed a sensitivity of 82% (95% CI: 73%, 91%) and a specificity of 89% (95% CI: 85%, 94%) in overall stenoses identification, of 90% (95% CI: 81%, 99%) and 90% (95% CI: 83%, 96%) for proximal segments, and of 68% (95% CI: 50%, 86%) and 81% (95% CI: 71%, 92%) for distal segments, respectively.

CONCLUSION: Navigator-echo, 3D MR coronary angiography is a promising sequence for assessing coronary arterial stenoses, but further improvements are required for distal segments.

Index terms: Coronary angiography, comparative studies, 54.12142, 54.1244 • Coronary vessels, diseases, 54.762 • Coronary vessels, MR, 54.121412, 54.121415, 54.12142 • Coronary vessels, stenosis or obstruction, 54.762 • Magnetic resonance (MR), three-dimensional, 54.12142 • Magnetic resonance (MR), vascular studies, 54.12142

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