Assessment of Coronary Artery Disease Using Magnetic Resonance Coronary Angiography A National Multicenter Trial

被引:188
作者
Kato, Shingo [1 ]
Kitagawa, Kakuya [1 ]
Ishida, Nanaka [1 ]
Ishida, Masaki [1 ]
Nagata, Motonori [1 ]
Ichikawa, Yasutaka [2 ]
Katahira, Kazuhiro [3 ]
Matsumoto, Yuji [4 ]
Seo, Koji [5 ]
Ochiai, Reiji [6 ]
Kobayashi, Yasuyuki [7 ]
Sakuma, Hajime [1 ]
机构
[1] Mie Univ Hosp, Dept Radiol, Tsu, Mie 5148507, Japan
[2] Matsusaka Cent Hosp, Dept Radiol, Matsusaka, Japan
[3] Kumamoto City Hosp, Dept Radiol, Kumamoto, Japan
[4] Saijyo Cent Hosp, Dept Cardiol, Saijyo, Japan
[5] Utsunomiya Cent Clin, Dept Cardiol, Utsunomiya, Tochigi, Japan
[6] Koga Hosp, Dept Radiol, Kurume, Fukuoka, Japan
[7] St Marianna Hosp, Dept Radiol, Kawasaki, Kanagawa, Japan
关键词
coronary artery; coronary artery disease; magnetic resonance angiography; national multicenter trial; DIAGNOSTIC PERFORMANCE; MR-ANGIOGRAPHY; COMPUTED-TOMOGRAPHY; STENOSIS; STATE; ACCURACY; MINUTES;
D O I
10.1016/j.jacc.2010.01.071
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives 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. (J Am Coll Cardiol 2010; 56: 983-91) c 2010 by the American College of Cardiology Foundation
引用
收藏
页码:983 / 991
页数:9
相关论文
共 20 条
[1]   Whole-heart coronary magnetic resonance angiography at 3 Tesla in 5 minutes with slow infusion of Gd-BOPTA, a high-relaxivity clinical contrast agent [J].
Bi, Xiaoming ;
Carr, James C. ;
Li, Debiao .
MAGNETIC RESONANCE IN MEDICINE, 2007, 58 (01) :1-7
[2]   Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative [J].
Bossuyt, PM ;
Reitsma, JB ;
Bruns, DE ;
Gatsonis, CA ;
Glasziou, PP ;
Irwig, LM ;
Lijmer, JG ;
Moher, D ;
Rennie, D ;
de Vet, HCW .
ANNALS OF INTERNAL MEDICINE, 2003, 138 (01) :40-44
[3]   Diagnostic Performance of 64-Multidetector Row Coronary Computed Tomographic Angiography for Evaluation of Coronary Artery Stenosis in Individuals Without Known Coronary Artery Disease [J].
Budoff, Matthew J. ;
Dowe, David ;
Jollis, James G. ;
Gitter, Michael ;
Sutherland, John ;
Halamert, Edward ;
Scherer, Markus ;
Bellinger, Raye ;
Martin, Arthur ;
Benton, Robert ;
Delago, Augustin ;
Min, James K. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 52 (21) :1724-1732
[4]   Cardiac MR imaging: State of the technology [J].
Finn, J. Paul ;
Nael, Kambiz ;
Deshpande, Vibhas ;
Ratib, Osman ;
Laub, Gerhard .
RADIOLOGY, 2006, 241 (02) :338-354
[5]   Rapid and complete coronary arterial tree visualization with magnetic resonance imaging: feasibility and diagnostic performance [J].
Jahnke, C ;
Paetsch, I ;
Nehrke, K ;
Schnackenburg, B ;
Gebker, R ;
Fleck, E ;
Nagel, E .
EUROPEAN HEART JOURNAL, 2005, 26 (21) :2313-2319
[6]   Comparison of radial and Cartesian imaging techniques for MR coronary angiography [J].
Jahnke, C ;
Paetsch, I ;
Schnackenburg, B ;
Gebker, R ;
Köhler, U ;
Bornstedt, A ;
Fleck, E ;
Nagel, E .
JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE, 2004, 6 (04) :865-875
[7]   Coronary magnetic resonance angiography for the detection of coronary stenoses [J].
Kim, WY ;
Danias, PG ;
Stuber, M ;
Flamm, SD ;
Plein, S ;
Nagel, E ;
Langerak, SE ;
Weber, OM ;
Pedersen, EM ;
Schmidt, M ;
Botnar, RM ;
Manning, WJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (26) :1863-1869
[8]   Assessment of the accuracy of diagnostic tests: the cross-sectional study [J].
Knottnerus, JA ;
Muris, JW .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2003, 56 (11) :1118-1128
[9]   Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0 T - Comparison with steady-state free precession technique at 1.5 T [J].
Liu, Xin ;
Bi, Xiaoming ;
Huang, Jie ;
Jerecic, Renate ;
Carr, James ;
Li, Debiao .
INVESTIGATIVE RADIOLOGY, 2008, 43 (09) :663-668
[10]   Comparison of 3D free-breathing coronary MR angiography and 64-MDCT angiography for detection of coronary stenosis in patients with high calcium scores [J].
Liu, Xin ;
Zhao, Xihai ;
Huang, Jie ;
Francois, Christopher J. ;
Tuite, David ;
Bi, Xiaoming ;
Li, Debiao ;
Carr, James C. .
AMERICAN JOURNAL OF ROENTGENOLOGY, 2007, 189 (06) :1326-1332