Comparison of contrast-enhanced breath-hold and free-breathing respiratory-gated imaging in three-dimensional magnetic resonance coronary angiography.
Suppression of respiratory motion is one of the major challenges of magnetic resonance (MR) coronary angiography. Two approaches to compensate for respiratory motion have often been proposed: breath-hold (BH) and free-breathing respiratory-gated (FBRG) imaging. So far, however, these approaches have never been directly compared. MR coronary angiography was performed in 32 patients with suspected coronary artery disease. MR data were acquired using contrast-enhanced BH and FBRG 3-dimensional MR coronary angiographic techniques. MR images were compared with regard to image quality using quantitative parameters and with regard to accuracy for stenosis detection in the proximal and mid-coronary segments in comparison to x-ray angiography. With regard to image quality, BH was superior to FBRG. Signal-to-noise ratio was 29.1 +/- 10.7 for BH versus 18.8 +/- 9.7 for FBRG (p <0.05) and contrast-to-noise was 18.0 +/- 7.4 for BH versus 11.3 +/- 7.9 for FBRG (p </=0.05). One hundered seventy-one of 224 coronary artery segments (76%) were evaluable in BH compared with 155 of 224 in FBRG (69%). In the evaluable segments, BH demonstrated a sensitivity of 87% (26 of 30 stenoses detected) and specificity of 92% (129 of 141 nonstenotic segments correctly identified), whereas FBRG showed a sensitivity of 60% (15 of 25) and specificity of 89% (115 of 130). Overall accuracy was 91% (155 of 171) for BH and 84% (130 of 155) for FBRG. Sensitivity was significantly higher for BH (p = 0.0320), whereas specificity and overall accuracy were not significantly different. Thus, contrast-enhanced BH MR coronary angiography compares favorably to FBRG imaging with regard to image quality and detection of coronary stenoses.
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods / Q000592:standards; D007275:Injections, Intravenous; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012119:Respiration; D012680:Sensitivity and Specificity
D003287:Contrast Media