Assessment of coronary artery disease using magnetic resonance coronary angiography: a national multicenter trial.
OBJECTIVE
This national multicenter study determined the diagnostic performance of 1.5-T whole-heart coronary magnetic resonance angiography (MRA) in patients with suspected coronary artery disease (CAD).


BACKGROUND
Whole-heart coronary MRA using steady-state free precession allows noninvasive detection of CAD without the administration of contrast medium. However, the accuracy of this approach has not been determined in a multicenter trial.


METHODS
Using a 1.5-T magnetic resonance imaging unit, free-breathing steady-state free precession whole-heart coronary MRA images were acquired for 138 patients with suspected CAD at 7 hospitals. The accuracy of MRA for detecting a ≥ 50% reduction in diameter was determined using X-ray coronary angiography as the reference method.


RESULTS
Acquisition of whole-heart coronary MRA images was performed in 127 (92%) of 138 patients with an average imaging time of 9.5 ± 3.5 min. The areas under the receiver-operator characteristic curve from MRA images according to vessel- and patient-based analyses were 0.91 (95% confidence interval [CI]: 0.87 to 0.95) and 0.87 (95% CI: 0.81 to 0.93), respectively. The sensitivity, specificity, positive and negative predictive values, and accuracy of MRA according to a patient-based analysis were 88% (49 of 56, 95% CI: 75% to 94%), 72% (51 of 71, 95% CI: 60% to 82%), 71% (49 of 69, 95% CI: 59% to 81%), 88% (51 of 58, 95% CI: 76% to 95%), and 79% (100 of 127, 95% CI: 72% to 86%), respectively.


CONCLUSIONS
Non-contrast-enhanced whole-heart coronary MRA at 1.5-T can noninvasively detect significant CAD with high sensitivity and moderate specificity. A negative predictive value of 88% indicates that whole-heart coronary MRA can rule out CAD.
Kato
Shingo
S
Department of Radiology, Mie University Hospital, Tsu, Japan.
Kitagawa
Kakuya
K
Ishida
Nanaka
N
Ishida
Masaki
M
Nagata
Motonori
M
Ichikawa
Yasutaka
Y
Katahira
Kazuhiro
K
Matsumoto
Yuji
Y
Seo
Koji
K
Ochiai
Reiji
R
Kobayashi
Yasuyuki
Y
Sakuma
Hajime
H
D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007548:Isosorbide Dinitrate; D007564:Japan; D018810:Magnetic Resonance Angiography; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate