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CLINICAL RESEARCH: NON-INVASIVE CORONARY ANGIOGRAPHY

Detection of Coronary Artery Stenosis With Whole-Heart Coronary Magnetic Resonance Angiography

Hajime Sakuma, MD^_*,_*, Yasutaka Ichikawa, MD, Shuji Chino, MD, Tadanori Hirano, MD, Katsutoshi Makino, MD and Kan Takeda, MD^_*

^_* Department of Radiology, Mie University Hospital, Mie, Japan
Department of Radiology, Matsusaka Central Hospital, Mie, Japan
Department of Internal Medicine, Matsusaka Central Hospital, Mie, Japan.

Manuscript received December 19, 2005; revised manuscript received June 21, 2006, accepted July 12, 2006.

^_* Reprint requests and correspondence: Dr. Hajime Sakuma, Department of Diagnostic Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. (Email: sakuma{at}clin.medic.mie-u.ac.jp).

OBJECTIVES: We sought to determine the diagnostic performance of whole-heart coronary magnetic resonance (MR) angiography for detecting significant coronary artery disease.

BACKGROUND: The accuracy of whole-heart coronary MR angiography has not been determined in a large number of patients.

METHODS: Three-dimensional coronary MR angiograms covering the entire heart were obtained during free breathing in 131 patients. Images were acquired during a patient-specific time window in the cardiac cycle with minimal motion of the coronary artery. Significant coronary artery disease was defined on X-ray coronary angiography as a diameter reduction of 50% in coronary arteries with a reference diameter of 2 mm.

RESULTS: The acquisition of MR angiography was completed in 113 (86%) of 131 patients, with an imaging time averaged at 12.9 ± 4.3 min. On a patient-based analysis, the sensitivity, specificity, positive and negative predictive value, and accuracy of MR angiography were 82% (95% confidence interval [CI] 69% to 91%), 90% (95% CI 79% to 96%), 88% (95% CI 74% to 95%), 86% (95% CI 75% to 93%), and 87% (95% CI 79% to 92%), respectively. These values in the individual segments were 78% (95% CI 68% to 85%), 96% (95% CI 95% to 97%), 69% (95% CI 60% to 77%), 98% (95% CI 96% to 98%), and 94% (95% CI 96% to 96%).

CONCLUSIONS: Whole-heart coronary MR angiography allows for noninvasive detection of significant narrowing in coronary arterial segments with a diameter of 2 mm with moderate sensitivity and high specificity.

Abbreviations and Acronyms   MR = magnetic resonance   RCA = right coronary artery

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