- Poster presentation
- Open Access
Additional value of first pass magnetic resonance myocardial perfusion imaging to computed tomography coronary angiography for detection of significant coronary artery disease
© Groothuis et al; licensee BioMed Central Ltd. 2009
- Published: 28 January 2009
- Coronary Artery Disease
- Compute Tomography Coronary Angiography
- Invasive Coronary Angiography
- Significant Coronary Artery Disease
- Suspected Coronary Artery Disease
As computed tomography coronary angiography (CTCA) has a reported excellent negative predictive value for detection of significant coronary artery disease (CAD), it is increasingly used as first line technique in the evaluation of patients with suspected CAD. However, positive predictive value is low and CTCA lacks information about myocardial perfusion. As first pass magnetic resonance myocardial perfusion imaging (MRMPI) can accurately assess myocardial perfusion and does not involve ionizing radiation, it may be a valuable additional technique to CTCA in the evaluation of patients with suspected CAD. Subsequently, their combined use may lower the number of unnecessary, costly invasive coronary angiographies (CAG).
The additional value of MRMPI to CTCA for detection of significant CAD was investigated using invasive coronary angiography as the standard of reference.
Patients with chest pain and intermediate pre-test probability CAD underwent both 64-slice CTCA (Sensation, Siemens, Erlangen) and adenosine stress and rest first pass MRMPI (1,5 Tesla MR scanner, Siemens, Erlangen). CTCA was scored per segment as: normal; non-obstructive CAD (0–50% diameter stenosis) and abnormal (>50% stenosis). MRMPI was analyzed qualitatively and was assessed as abnormal in case of any segment with a perfusion defect. In case of abnormal CTCA and/or abnormal MRMPI, CAG was performed. Significant CAD was defined as > 70% diameter stenosis on CAG.
By using MRMPI as additional technique in case of abnormal CTCA findings, significant CAD could be ruled out in 14 of 37 (38%) patients with abnormal CTCA. In case of normal CTCA however, the additional value of MRMPI for detection of significant CAD is low.
This article is published under license to BioMed Central Ltd.