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Assessment of coronary artery disease using 3.0 T magnetic resonance coronary angiography: a national multicenter trial

Background

3.0T contrast enhanced whole-heart coronary magnetic resonance angiography (MRA) is a promising method for noninvasive, radiation-free detection and exclusion of obstructive coronary artery disease (CAD); however, the accuracy of this approach has not been determined in a multicenter trial.

Methods

An ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence was used for image acquisition in 272 patients with suspected CAD at 8 hospitals. The accuracy of coronary MRA for detecting a 50% diameter reduction was determined using X-ray coronary angiography as the reference method. Using an intention-to-diagnose approach, all coronary arteries were included for the evaluation regardless of the image quality of coronary MRA to avoid overestimation of the diagnostic accuracy. Clinical Trial Registration—URL: http://clinicaltrials.gov. Unique identifier: NCT01024478.

Results

Acquisition of coronary MRA was successfully completed in 235 of 272 (86%) patients with average imaging time of 9.5±1.6 minutes. The areas under the receiver-operator characteristic curve from MRA images according to vessel- and patient-based analyses were 0.90 (95% confidence interval [CI]: 0.88 to 0.95) and 0.88 (95% CI: 0.83 to 0.93), respectively. The sensitivity and specificity of MRA on per-patient basis were 91% and 80%, respectively.

Figure 1
figure1

Curved planar reconstruction (CPR) image (A), Sliding thin slab maximum intensity projection (MIP) image (B), MIP image of coronary tree (C), and volume-rendered image (D) detect coronary artery stenoses in the LAD (arrow) and first diagonal branch (arrowhead). Good agreement is observed between coronary MRA and X-ray coronary angiography.

Conclusions

Among patients who were scheduled to obtain conventional x-ray coronary angiography, we found that coronary MRA at 3.0T demonstrates high accuracy for detection of significant coronary artery stenosis. It warrants greater consideration as a suitable noninvasive method to exclude obstructive CAD.

Funding

National Basic Research Program 973 (grant no. 2010CB732600) from Ministry of Science and Technology, China; National Natural Science Foundation of China, grant number 30900355; National Institute of Health, grants numbers NIBIB EB002623 and NHLBI HL38698.

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Correspondence to Qi Yang.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Yang, Q., Li, K., Sun, B. et al. Assessment of coronary artery disease using 3.0 T magnetic resonance coronary angiography: a national multicenter trial. J Cardiovasc Magn Reson 15, E5 (2013). https://doi.org/10.1186/1532-429X-15-S1-E5

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Keywords

  • Coronary Artery Disease
  • Magnetic Resonance Angiography
  • Coronary Artery Stenosis
  • Obstructive Coronary Artery Disease
  • Suspected Coronary Artery Disease