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Head-to-Head Comparison of Three-Dimensional Navigator-Gated Magnetic Resonance Imaging and 16-Slice Computed Tomography to Detect Coronary Artery Stenosis in Patients

Joëlle Kefer, MD^_*, Emmanuel Coche, MD, Gabin Legros, MD^_*,2, Agnès Pasquet, MD^_*, Cécile Grandin, MD, Bernard E. Van Beers, MD, Jean-Louis Vanoverschelde, MD, FACC^_* and Bernhard L. Gerber, MD^_*,1,_*

^_* Division of Cardiology, Cliniques Universitaires St. Luc UCL, Brussels, Belgium
Division of Radiology, Cliniques Universitaires St. Luc UCL, Brussels, Belgium

View larger version (92K): [in a new window]   Figure 1 Quantitative analysis of left anterior descending coronary artery (LAD) stenosis by multidetector row computed tomography (MDCT). Calcified plaque (gray striped) was removed from lumen contours (thick white border). MLD = minimal luminal diameter in area of obstruction (Obs); RVD = reference vessel diameter in non-diseased area (Ref).

View larger version (77K): [in a new window]   Figure 2 Typical examples of reformatted magnetic resonance (MR) (left panels), and multidetector row computed tomography (MDCT) (center panels) and corresponding quantitative coronary angiography (QCA) images (right panels) of the right (RCA) (top panels) and left coronary artery systems (LCA) (bottom panels). (A) Normal right and left coronary arteries by MR, MDCT, and QCA. (B) Isolated mid-RCA stenosis (arrows) evaluated at 40% diameter stenosis (DS) using MR, 58% DS using MDCT, and 86% DS by QCA. (C) Two-vessel disease involving the mid-LAD (black arrows), evaluated at 37% DS using MR, 51% DS using MDCT, and 52% DS using QCA and left circumflex coronary artery (white arrows) evaluated at 64% DS using MR, 57% DS using MDCT, and 79% DS using QCA.

View larger version (26K): [in a new window]   Figure 3 Visual diagnostic accuracies of magnetic resonance and multidetector row computed tomography for detection of >50% diameter stenosis on a per-segment basis (A) and per-vessel basis (B). NPV = negative predictive value; PPV = positive predictive value; Sens = sensitivity; Spec = specificity.

View larger version (48K): [in a new window]   Figure 4 Correlations and Bland-Altman plots between measurements of diameter stenosis (DS) by magnetic resonance (MR) (top) and multidetector row computed tomography (MDCT) (bottom) versus quantitative coronary angiography (QCA).

View larger version (22K): [in a new window]   Figure 5 Receiver-operating characteristic curves comparing diagnostic accuracies of visual and quantitative measurement of diameter stenosis (DS) by magnetic resonance (MR) and multidetector row computed tomography (MDCT) for detection of >50% DS by quantitative coronary angiography on a per-segment basis (A) and per-vessel basis (B). AUC = area under curve.