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EXPEDITED PUBLICATION

Contrast-Enhanced Whole-Heart Coronary Magnetic Resonance Angiography at 3.0-T

A Comparative Study With X-Ray Angiography in a Single Center

Qi Yang, MD^_*, Kuncheng Li, MD, PhD^_*,_*, Xin Liu, MD, Xiaoming Bi, PhD, Zhi Liu, MD^_*, Jing An, MS, Al Zhang, PhD, Renate Jerecic, PhD^|| and Debiao Li, PhD

^_* Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
Department of Radiology, Northwestern University, Chicago, Illinois
Siemens Medical Solutions USA, Inc., Chicago, Illinois
Siemens Mindit Magnetic Resonance Ltd., Shenzhen, China
^|| Siemens Ltd. China, Healthcare Magnetic Resonance, Shanghai, China

Manuscript received December 18, 2008; revised manuscript received February 17, 2009, accepted March 10, 2009.

^_* Reprint requests and correspondence: Dr. Kuncheng Li, No. 45 Changchun Street, Xuanwu District, Beijing 100053, China (Email: likuncheng1955{at}yahoo.com.cn).

Objectives: The purpose of this study was to prospectively evaluate the diagnostic performance of 3.0-T contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) in patients with suspected coronary artery disease (CAD).

Background: A slow-infusion, contrast-enhanced whole-heart CMRA approach has recently been developed at 3.0-T. The accuracy of this technique has not yet been determined among patients with suspected CAD.

Methods: The 3.0-T contrast-enhanced whole-heart CMRA was performed in 69 consecutive patients. An electrocardiography-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence was used to acquire isotropic whole-heart CMRA with slow infusion of 0.2 mmol/kg gadobenate dimeglumine. The diagnostic accuracy of whole-heart CMRA in detecting significant stenoses (50%) was evaluated using X-ray angiography as the reference.

Results: The CMRA examinations were successfully completed in 62 patients. Acquisition time of whole-heart CMRA procedure was 9.0 ± 1.9 min. The 3.0-T whole-heart CMRA correctly identified significant CAD in 32 patients and correctly ruled out CAD in 23 patients. The sensitivity, specificity, and accuracy of whole-heart CMRA for detecting significant stenoses were 91.6% (87 of 95), 83.1% (570 of 686), and 84.1% (657 of 781), respectively, on a per-segment basis. These values were 94.1% (32 of 34), 82.1% (23 of 28), and 88.7% (55 of 62), respectively, on a per-patient basis.

Conclusions: Contrast-enhanced whole-heart CMRA with 3.0-T allows for the accurate detection of coronary artery stenosis with high sensitivity and moderate specificity.

Key Words: coronary disease • magnetic resonance imaging • contrast media • 3.0-T

Abbreviations and Acronyms   CAD = coronary artery disease   CMRA = coronary magnetic resonance angiography   CNR = contrast-to-noise ratio   ECG = electrocardiography   FLASH = fast low-angle shot   QCA = quantitative coronary angiography   RCA = right coronary artery   RF = radiofrequency   SNR = signal-to-noise ratio   SSFP = steady-state free precession   TR = repetition time

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