Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging.
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.
Dewey
Marc
M
Department of Radiology, Charité Medical School, Humboldt-Universität, Berlin, Germany. marc.dewey@charite.de
Teige
Florian
F
Schnapauff
Dirk
D
Laule
Michael
M
Borges
Adrian C
AC
Wernecke
Klaus-Dieter
KD
Schink
Tania
T
Baumann
Gert
G
Rutsch
Wolfgang
W
Rogalla
Patrik
P
Taupitz
Matthias
M
Hamm
Bernd
B
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