Whole-heart-coronary-MRA (WH-CMRA) or black-blood-coronary-arterial-wall imaging have been used independently to detect coronary artery disease (CAD) in previous studies [1, 2]. However, the diagnostic performance of a combined approach hasn't been reported yet.

To evaluate the diagnostic performance of combined non-contrast WH-CMRA and black-blood-arterial-wall imaging in patients with suspected CAD.

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%.

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.