title: Direct comparison of whole-heart navigator-gated magnetic resonance coronary angiography and 40- and 64-slice multidetector row computed tomography to detect the coronary artery stenosis in patients scheduled for conventional coronary angiography.
abstract: BACKGROUND
  Both whole-heart magnetic resonance coronary angiography (WH-MRCA) and multidetector computed tomography (MDCT) have been proposed for the noninvasive identification of the coronary stenosis. The authors sought to directly compare the diagnostic accuracy of these noninvasive imaging techniques using the invasive quantitative coronary angiography as a reference standard.
  
  
  RESULTS
  Seventy-seven consecutive patients (56 men, 61+/-14 years) prospectively underwent WH-MRCA and 40- or 64-slice MDCT before the quantitative coronary angiography. Diagnostic accuracy of WH-MRCA and MDCT for the visual identification of >50% diameter stenosis in segments of >1.5 mm size was compared using the quantitative coronary angiography as a reference. According to the quantitative coronary angiography, 49 of 992 coronary segments >1.5 mm diameter had >50% diameter stenosis. MDCT had a higher success rate (100% versus 88%, P<0.001) and enabled identification of more segments (963 versus 726, P<0.001) than did WH-MRCA. On a per-segment basis, WH-MRCA had similar sensitivity (47/49 or 96% versus 48/49 or 98%, P=0.9) but significantly lower specificity (644/943 or 68% versus 863/943 or 92%, P<0.001) and accuracy (691/992 or 70% versus 911/992 or 92%, P<0.001) for the detection of >50% diameter stenosis than did MDCT. On a per-patient basis, the sensitivity was similar (17/17 or 100% versus 16/17 or 94%, P=0.9), but specificity (43/60 or 72% versus 53/60 or 88%, P=0.024) and diagnostic accuracy (60/77 or 78%, versus 69/77 or 90%, P=0.044) of WH-MRCA for the detection of >50% diameter stenosis were significantly lower than of MDCT.
  
  
  CONCLUSIONS
  Because of the higher success rate and higher number of interpretable segments, 40- or 64-slice MDCT performs better than WH-MRCA.
authors.affiliation: Divisions of Cardiology, Cliniques Universitaires St. Luc UCL, Brussels, Belgium.
authors.forename: Anne-Catherine
authors.initials: AC
authors.lastname: Pouleur
authors.forename: Jean-Benoît
authors.initials: JB
authors.lastname: le Polain de Waroux
authors.forename: Joelle
authors.initials: J
authors.lastname: Kefer
authors.forename: Agnès
authors.initials: A
authors.lastname: Pasquet
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vanoverschelde
authors.forename: Bernhard L
authors.initials: BL
authors.lastname: Gerber
mesh_terms: D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed