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CLINICAL RESEARCH: CARDIAC IMAGING

Delayed-Enhancement Cardiovascular Magnetic Resonance Coronary Artery Wall Imaging

Comparison With Multislice Computed Tomography and Quantitative Coronary Angiography

Susan B. Yeon, MD, JD, FACC^_*,_*, Adeel Sabir, MD, Melvin Clouse, MD^,1, Pedro O. Martinezclark, MD^_*, Dana C. Peters, PhD^_*, Thomas H. Hauser, MD, MMSc, MPH, FACC^_*, C. Michael Gibson, MS, MD, FACC^_*, Reza Nezafat, PhD^_*, David Maintz, MD, Warren J. Manning, MD, FACC, FAHA^_*,,1 and René M. Botnar, PhD

^_* Department of Medicine (Cardiovascular Division), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
Department of Clinical Radiology, University of Muenster, Muenster, Germany
Department of Nuclear Medicine, Technical University Munich, Munich, Germany.

Manuscript received October 25, 2006; revised manuscript received March 15, 2007, accepted March 28, 2007.

^_* Reprint requests and correspondence: Dr. Susan Yeon, Beth Israel Deaconess Medical Center, Cardiovascular Division, 330 Brookline Avenue, Boston, Massachusetts 02215. (Email: syeon{at}bidmc.harvard.edu).

Objectives: We examined whether delayed-enhancement cardiovascular magnetic resonance (DE-CMR) coronary artery wall imaging correlated with atherosclerosis detected by using multislice computed tomography (MSCT) and quantitative coronary angiography (QCA).

Background: The use of DE-CMR coronary vessel wall imaging may provide a noninvasive method to assess diseased coronary vessel walls.

Methods: We performed DE-CMR coronary artery wall imaging in 14 patients with cardiovascular risk factors and 6 healthy subjects without risk factors.

Results: A greater prevalence of strong DE was noted with greater MSCT evidence of disease, with DE in 2 (7%) of 30 coronary segments with no plaque by MSCT, in 1 (10%) of 10 segments with noncalcified plaque on MSCT, and in 16 (36%) of 44 segments with calcifications by MSCT (p = 0.009, adjusted p = 0.035). Delayed enhancement was observed in 8 (53%) of 15 segments with >20% coronary artery stenosis by QCA but also in 12 (15%) of 80 segments without angiographically apparent coronary disease (p = 0.004, adjusted p = 0.01).

Conclusions: The use of DE-CMR allowed us to identify areas of DE that correlate with severity of atherosclerosis by MSCT and QCA. This novel approach may be useful for the assessment of coronary vessel wall in patients with suspected coronary artery disease.

Abbreviations and Acronyms   CATH = X-ray coronary angiography   CMR = cardiovascular magnetic resonance   CNR = contrast-to-noise   DE = delayed enhancement   MSCT = multislice computed tomography   QCA = quantitative coronary angiography

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