Additive Value of Magnetic Resonance Coronary Angiography in a Comprehensive Cardiac Magnetic Resonance Stress-Rest Protocol for Detection of Functionally Significant Coronary Artery Disease A Pilot Study

• Type: Article in International Scientific Journal
• Date: 2013

Authors

Bettencourt, N (Author) Other; Ferreira, N (Author) Other; Chiribiri, A (Author) Other; Schuster, A (Author) Other; Sampaio, F (Author) Other; Santos, L (Author) Other; Melica, B (Author) Other; Rodrigues, A (Author) Other; Braga, P (Author) Other; Teixeira, M (Author) Other; Leite-Moreira AF (Author) FMUP; Silva Cardoso, J (Author) FMUP; Portugal, P (Author) Other; Gama, V (Author) Other; Nagel, E (Author) Other

Journal

Title: Circulation. Cardiovascular imaging

Vol. 6

Pages: 730-738

ISSN: 1941-9651

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 19 Citations

Scopus - 17 Citations

Other information

Authenticus ID: P-006-7E0

DOI: 10.1161/circimaging.113.000280

Abstract (EN): Background Cardiovascular magnetic resonance (CMR) myocardial perfusion imaging (MPI) is a state-of-the-art noninvasive modality for detection of myocardial ischemia and coronary artery disease. Magnetic resonance coronary angiography (MRCA) allows visualization of the coronary tree, but its incremental value as part of a CMR protocol including MPI and late gadolinium enhancement (LGE) is not well established. We aimed to evaluate the additive diagnostic value of a 3-dimensional whole-heart MRCA integration into a 1.5T CMR-MPI/LGE protocol for the detection of functionally significant coronary artery disease. Methods and Results Forty-three symptomatic patients (618.3 years; 65% men) with suspected coronary artery disease and intermediate/high-pretest probability underwent CMR (including CMR-MPI, MRCA, and LGE) and x-ray invasive coronary angiography (XA) with fractional flow reserve evaluation. Diagnostic performances of MRCA, CMR-MPI/LGE, and MRCA+CMR-MPI/LGE integration were determined having XA+fractional flow reserve as standard for coronary artery disease (90% stenosis/occlusion or fractional flow reserve0.80 in vessels>2 mm). MRCA inclusion into the CMR protocol was associated with a mean increase of 7.9 +/- 4.69 (0-17.7) minutes in total examination duration (14%). On patient-based analysis, MRCA had 96% sensitivity, 68% specificity, positive predictive value of 79%, and negative predictive value of 93%. CMR-MPI/LGE had 79% sensitivity, 95% specificity, positive predictive value of 95%, and negative predictive value of 78%. Integration of MRCA with CMR-MPI/LGE further improved CMR performance to 96% sensitivity, 89% specificity, positive predictive value of 92%, and negative predictive value of 94%, with a global accuracy of 93%. Conclusions In this intermediate/high-pretest population, integration of noncontrast-enhanced whole-heart MRCA nonsignificantly improved per-patient diagnostic accuracy of a comprehensive 1.5-T stress-rest CMR-MPI/LGE protocol at a cost of longer scanning times.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9