title: Diagnostic accuracy of stress myocardial perfusion MRI and late gadolinium-enhanced MRI for detecting flow-limiting coronary artery disease: a multicenter study.
abstract: The aim of this study was to determine the diagnostic performance of stress and rest perfusion magnetic resonance imaging (MRI) and late gadolinium-enhanced (LGE) MRI for identifying patients with obstructive coronary artery disease (CAD). A total of 50 patients with suspected CAD underwent stress-rest perfusion MRI, followed by LGE MRI with a 1.5-T system. Stress-rest perfusion MRI resulted in an area under the receiver-operating characteristic curve (AUC) of 0.92 for observer 1 and 0.84 for observer 2 with sensitivity and specificity of 89% (32/36) and 79% (11/14) by observer 1, 83% (30/36) and 71% (10/14) by observer 2, respectively, showing a moderate interobserver agreement (Cohen's kappa = 0.49). While combination of stress-rest perfusion and LGE MRI did not result in improved accuracy for the prediction of flow-limiting obstructive CAD (AUC 0.81 for observer 1 and 0.80 for observer 2), the sensitivity was increased to 92% in both observers with a substantial interobserver agreement (kappa = 0.70). Stress-rest myocardial perfusion MRI is an accurate diagnostic test for identifying patients with obstructive CAD.
authors.affiliation: Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
authors.forename: Kakuya
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakuma
authors.forename: Motonori
authors.initials: M
authors.lastname: Nagata
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okuda
authors.forename: Masaharu
authors.initials: M
authors.lastname: Hirano
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanimoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsusako
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D023921:Coronary Stenosis / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007564:Japan; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA