Three-dimensional breathhold magnetization-prepared TrueFISP: a pilot study for magnetic resonance imaging of the coronary artery disease.
OBJECTIVE
X-ray angiography is currently the standard test for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this work was the evaluation of the accuracy of a three-dimensional (3D) breathhold coronary magnetic resonance angiography (MRA) technique in detecting hemodynamically significant coronary artery stenoses in a patient population with x-ray angiographic correlation.


METHODS
Sequential subjects (n = 33, M/F = 22/11, average age = 57) who were referred for conventional coronary angiography were enrolled in the study. The study protocol was approved by our institutional review board. Each subject gave written informed consent. Volume-targeted 3D breathhold coronary artery scans with ECG-triggered, segmented True Fast Imaging with Steady-state Precession (TrueFISP) were acquired for the left main (LM), left anterior descending (LAD), and right coronary arteries (RCAs). Coronary MRA was evaluated with conventional angiography as the gold standard.


RESULTS
The overall sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing any hemodynamically significant coronary artery disease (> or =50% diameter reduction) with coronary MRA was 87%, 57%, 72%, 68%, and 80%, respectively. The sensitivity of the technique in the LM, LAD, and RCA was 100%, 83%, and 100%, respectively. The NPV of the technique in the LM, LAD, and RCA was 100%, 82%, and 100%, respectively.


CONCLUSIONS
Three-dimensional breathhold True Fast Imaging with Steady-state Precession is a promising technique for coronary artery imaging. It has a relatively high sensitivity and NPV. Results of this study warrant further technical improvements and clinical evaluation of the technique.
McCarthy
Richard M
RM
Department of Radiology, Northwestern University, Chicago, Illinois 60611, USA.
Deshpande
Vibhas S
VS
Beohar
Nirat
N
Meyers
Sheridan N
SN
Shea
Steven M
SM
Green
Jordin D
JD
Liu
Xin
X
Bi
Xiaoming
X
Pereles
F Scott
FS
Finn
John Paul
JP
Davidson
Charles J
CJ
Carr
James C
JC
Li
Debiao
D
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000175:diagnosis / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012680:Sensitivity and Specificity