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- Open Access
Diagnostic performance of non-contrast whole-heart coronary magnetic resonance angiography combined with black-blood arterial wall imaging in patients with suspected coronary artery disease
https://doi.org/10.1186/1532-429X-12-S1-P38
© Dai et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
Keywords
- Coronary Artery Disease
- Arterial Wall
- Leave Anterior Descend
- Diagnostic Performance
- Right Coronary Artery
Introduction
Purpose
To evaluate the diagnostic performance of combined non-contrast WH-CMRA and black-blood-arterial-wall imaging in patients with suspected CAD.
Methods
Thirteen patients with suspected CAD were scanned at 1.5 T (MAGNETOM Sonata, Siemens, Germany) after written informed consent was obtained. WH-CMRA was acquired using a 3D ECG-triggered, navigator-gated, fat-suppressed, T2-prepared steady-state-free-precession sequence. Cross-sectional coronary wall imaging (thinkness = 5 mm) was performed using a 2D-black-blood, navigator and ECG-gated, Turbo-Spin-Echo sequence with asymmetric-adiabatic-spectral inversion-recovery fat suppression [3]. Continous slices without gap for wall imaging were positioned from pre to post of the suspected lesion segment perpendicular to the multi-planar reformats (MPRs) of WH-CMRA. All patients received SCA within 1 week before or after the MR examination. Image quality of WH-CMRA and vessel wall images was evaluated on a segment basis by 4-point scale (1 - poor, 4 - excellent). Segments with a score of 1 in both techniques were excluded from analysis. A positive diagnosis of CAD was made based on the MR images when at least in one of both techniques a stenosis ≥ 50% was detected by visual analysis. Only left main (LM), proximal and middle segments of right coronary artery (RCA)/left anterior descending coronary artery (LAD) were included in our study. CAD was defined positive on SCA when showing a luminal diameter reduction ≥ 50%.
Results
Patient population and results of non-contrast WH-CMRA and black blood arterial wall compared with SCA.
Patient | BMI | HR | Location | WH-CMRA | IQ WH-CMRA | Vessel Wall | IQ Vessel Wall | Match CMRA-V. Wall | Combined MR diagnosis | Stenosis on SCA | Match MR-SCA | Follow Up |
---|---|---|---|---|---|---|---|---|---|---|---|---|
P01, M/32 | 28.38 | 69 | LAD proximal | + | 4 | + | 4 | Y | + | 80% | Y | stent |
LAD middle | + | 4 | + | 4 | Y | + | 75% | Y | stent | |||
P02, M/37 | 26.77 | 68 | LM | - | 4 | - | 4 | Y | - | - | Y | - |
P03, M/45 | 29.04 | 60 | LAD middle | - | 4 | - | 4 | Y | - | - | Y | - |
P04, M/49 | 24.49 | 75-80 | LAD proximal | - | 3 | + | 3 | N | + | 50-60% | Y | - |
P05, M/63 | 22.04 | 71 | RCA proximal | + | 4 | + | 4 | Y | + | 80-90% | Y | stent |
RCA middle | + | 4 | + | 4 | Y | + | 80-90% | Y | stent | |||
P06, F/72 | 33.33 | 82-93 | LM | - | 3 | ? | 1 | N | - | - | Y | - |
LAD proximal | - | 3 | ? | 1 | N | - | - | Y | - | |||
P07, F/67 | 34.17 | 73 | LAD proximal | - | 2 | - | 2 | Y | - | 60% | N | - |
P08, M/59 | 27.04 | 68 | LAD middle | + | 4 | + | 4 | Y | + | 60-70% | Y | - |
P09, M/54 | 25.56 | 60 | LAD proximal | - | 3 | - | 4 | Y | - | - | Y | - |
RCA proximal | - | 3 | - | 4 | Y | - | - | Y | - | |||
P10, M/48 | 25.39 | 72-79 | LAD proximal | - | 3 | - | 3 | Y | - | - | Y | - |
P11, M/46 | 26.58 | 65-72 | RCA proximal | - | 3 | - | 3 | Y | - | - | Y | - |
RCA middle | - | 3 | - | 3 | Y | - | - | Y | - | |||
P12, M/57 | 26.45 | 65 | LAD proximal | + | 4 | + | 4 | Y | + | 80% | Y | stent |
LAD middle | + | 4 | + | 4 | Y | = | 85% | Y | stent | |||
P13, M/62 | 20/07 | 60 | LAD middle | + | 4 | + | 4 | Y | + | 70% | Y | CABG |
RCA proximal | - | 4 | - | 4 | Y | - | - | Y | - |
59-Y man w. typical chest pain. MPRs of WH-CMRA (1b, 1c) show significant stenosis (≥ 50%) in middle segments of LAD, consistent with findings of SCA (1a). 2D black blook coronary wall images were acquired pre/mid/post LAD lesion (1d). Mid slice shows stenosis >50% while lumen in slice pre, post is <50%.
Conclusion
The combination of WH-CMRA and black blood coronary wall imaging improves diagnostic accuracy to detect CAD over WH-CMRA alone. The study with larger sample size is under investigation.
Authors’ Affiliations
References
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Copyright
This article is published under license to BioMed Central Ltd.