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Cardiac Imaging |
1 From the Departments of Cardiology, Thoraxcenter (R.J.M.v.G., B.J.W.M.R., M.H., P.J.d.F.) and Radiology, Daniel den Hoed Kliniek (P.A.W., H.G.d.B., P.M.A.v.O., M.O.), University Hospital Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam, the Netherlands. From the 1998 RSNA Scientific Assembly. Received July 28, 1999; revision requested September 1; revision received February 17, 2000; accepted April 4. Address correspondence to R.J.M.v.G. (e-mail: vangeuns@card.azr.nl).
PURPOSE: To assess the clinical value of a magnetic resonance (MR) coronary angiography strategy involving a small targeted volume to image one coronary segment in a single breath hold for the detection of greater than 50% stenosis.
MATERIALS AND METHODS: Thirty-eight patients referred for elective coronary angiography were included. The coronary arteries were localized during single-breath-hold, three-dimensional imaging of the entire heart. MR coronary angiography was then performed along the major coronary branches with a double-oblique, three-dimensional, gradient-echo sequence. Conventional coronary angiography was the reference-standard method.
RESULTS: Adequate visualization was achieved with MR coronary angiography in 85%–91% of the proximal coronary arterial branches and in 38%–76% of the middle and distal branches. Overall, 187 (69%) of 272 segments were suitable for comparison between conventional and MR coronary angiography. The diagnostic accuracy of MR coronary angiography for the detection of hemodynamically significant stenoses was 92%; sensitivity, 68%; and specificity, 97%. The sensitivity in individual segments was 50%–77%, whereas the specificity was 94%–100%.
CONCLUSION: Adequate visualization of the major coronary arterial branches was possible in the majority of patients. The observed accuracy of MR coronary angiography for detection of hemodynamically significant coronary arterial stenosis is promising, but it needs to be higher before this modality can be used reliably in a clinical setting. Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/217/1/270/DC1
Index terms: Coronary angiography, 548.1244 • Coronary vessels, MR, 548.121412, 548.121415, 548.121417, 548.12142 • Coronary vessels, stenosis or obstruction, 548.76 • Magnetic resonance (MR), vascular studies, 548.12142
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