A clinical strategy to improve the diagnostic accuracy of 1.5-T non-contrast MR coronary angiography for detection of co
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CARDIAC
A clinical strategy to improve the diagnostic accuracy of 1.5-T non-contrast MR coronary angiography for detection of coronary artery disease: combination of whole-heart and volume-targeted imaging Lu Lin 1 & Liang Wang 2 & Xiao-Na Zhang 3 & Xiao Li 1 & Jian Wang 1 & Zhu-Jun Shen 2 & Wei Chen 2 & Zheng-Yu Jin 1 & Yi-Ning Wang 3 Received: 17 March 2020 / Revised: 30 May 2020 / Accepted: 31 July 2020 # European Society of Radiology 2020
Abstract Objectives To evaluate the diagnostic performance of 1.5-T non-contrast MR coronary angiography (MRCA) for detection of coronary artery disease (CAD) using whole-heart imaging combined with volume-targeted imaging. Methods Forty-five patients scheduled for conventional coronary angiography (CAG) underwent 1.5-T free-breathing noncontrast steady-state free-precession MRCA, including whole-heart and subsequent three-vessel volume-targeted imaging. Coronary stenosis was evaluated as follows: (1) by whole-heart MRCA alone; (2) by combined MRCA (whole-heart plus volume-targeted images). The diagnostic performance for significant stenosis (≥ 50% diameter reduction) was evaluated and compared using CAG as a reference standard. Results Combined MRCA was completed in all 45 patients with a total acquisition time of 16.6 ± 3.3 min. The sensitivity, specificity, and accuracy of combined MRCA per patient were 97% (95% confidence interval 84–100%), 83% (52–98%), and 93% (82–98%), respectively. The areas under the receiver operating characteristic curve of combined MRCA were significantly higher than those of whole-heart MRCA on a per patient (0.97 versus 0.85, p = 0.0078) and per vessel (0.96 versus 0.86, p < 0.0001) basis. Compared with whole-heart MRCA, combined MRCA showed equally high sensitivity but significantly improved specificity on a per patient (83% versus 25%, p = 0.016) and per vessel (85% versus 50%, p < 0.0001) basis. Conclusions 1.5-T non-contrast MRCA combining whole-heart and volume-targeted imaging can detect significant CAD with high sensitivity and moderate specificity. Combined MRCA significantly improves specificity compared with whole-heart imaging alone. Key Points • 1.5-T non-contrast MRCA with combined whole-heart and volume-targeted imaging can detect CAD with high sensitivity and moderate specificity comparable with coronary CTA. • Compared with whole-heart imaging alone, combined imaging provides improved diagnostic accuracy, especially specificity. Keywords Magnetic resonance angiography . Coronary artery disease . Coronary angiography . Diagnostic test
Lu Lin and Liang Wang contributed equally to this work Yining Wang is the first corresponding author and Zheng-Yu Jin is the second corresponding author of this work. * Zheng-Yu Jin [email protected]
2
Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing 100730, China
3
Department of Health Care & Department of Radiology, Peking Union Medical College Hospital, Chinese A
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