title: Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging.
abstract: BACKGROUND
  Multislice computed tomography (CT) and magnetic resonance imaging (MRI) are the main candidates for noninvasive coronary angiography; however, multislice CT, unlike MRI, exposes patients to radiation and an iodinated intravenous contrast agent.
  
  
  OBJECTIVE
  To compare the diagnostic accuracy of multislice CT and MRI for noninvasive detection of clinically significant coronary stenoses (> or =50%).
  
  
  METHODS
  Prospective intention-to-diagnose study.
  
  
  METHODS
  Single tertiary referral center, Berlin, Germany.
  
  
  METHODS
  129 consecutive patients with suspected coronary artery disease.
  
  
  METHODS
  Multislice CT and MRI were both performed within a median of 1 day before conventional coronary angiography, which served as the reference standard.
  
  
  METHODS
  Diagnostic performance of multislice CT and MRI.
  
  
  RESULTS
  129 patients completed the study. Altogether, 108 patients with 430 vessels could be examined with both multislice CT and MRI and were used for analysis. In the per-patient analysis, the sensitivity of multislice CT (92% [95% CI, 82% to 96%]) was significantly higher than that of MRI (74% [CI, 61% to 83%]; P = 0.013). The sensitivity for detecting clinically significant stenoses was 82% for multislice CT and 54% for MRI (P < 0.001). Specificity and negative predictive value of multislice CT and MRI in the per-vessel analysis were 90% versus 87% (P = 0.73) and 95% versus 90% (P = 0.032), respectively. The effective radiation dose used with multislice CT (mean, 12.3 mSv [SD, 1.4]) in a consecutive subgroup of 73 patients was not significantly different from that used with diagnostic cardiac catheterization (11.4 mSv [SD, 4.8]) (P = 0.169). Most patients (74%) indicated that they would prefer multislice CT for future diagnostic imaging (P < 0.001).
  
  
  CONCLUSIONS
  This was a single-center study with 129 patients.
  
  
  CONCLUSIONS
  In patients referred for conventional coronary angiography, multislice CT compares favorably with MRI for noninvasive detection of coronary stenoses.
authors.affiliation: Department of Radiology, Charité Medical School, Humboldt-Universität, Berlin, Germany. marc.dewey@charite.de
authors.forename: Marc
authors.initials: M
authors.lastname: Dewey
authors.forename: Florian
authors.initials: F
authors.lastname: Teige
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.forename: Michael
authors.initials: M
authors.lastname: Laule
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rutsch
authors.forename: Patrik
authors.initials: P
authors.lastname: Rogalla
authors.forename: Matthias
authors.initials: M
authors.lastname: Taupitz
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
mesh_terms: D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D018810:Magnetic Resonance Angiography; D017060:Patient Satisfaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed