Clinical Research
Comparison of Cardiac Imaging
Head-to-Head Comparison of Three-Dimensional Navigator-Gated Magnetic Resonance Imaging and 16-Slice Computed Tomography to Detect Coronary Artery Stenosis in Patients

https://doi.org/10.1016/j.jacc.2005.03.057Get rights and content
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Objectives

The purpose of this research was to compare the diagnostic accuracy of three-dimensional navigator-gated magnetic resonance (MR) imaging and 16-slice multidetector row computed tomography (MDCT) versus quantitative coronary angiography (QCA) for the detection of coronary artery stenosis in patients.

Background

Both MR and MDCT are novel non-invasive tests, which have been proposed for noninvasive detection of coronary artery disease. Yet their diagnostic accuracy has not been directly compared in the same population.

Methods

Fifty-two patients underwent coronary MR and 16-slice MDCT before invasive coronary angiography. Diameter stenosis (DS) severity in vessels >1.5-mm reference diameter were graded visually and measured quantitatively on both MR and MDCT images. Diagnostic accuracy of both methods was compared using QCA as the reference test.

Results

According to QCA, 81 of 452 (18%) coronary segments with >1.5 mm diameter had >50% DS. By visual analysis, MR and MDCT had similar sensitivity (75% vs. 82%, p = NS), specificity (77% vs. 79%, p = NS), and diagnostic accuracy (77%, vs. 80%, p = NS) for detection of >50 % DS. Quantitative measures of DS by MR (r = 0.60, p < 0.001) and MDCT (r = 0.75, both p < 0.001) correlated well with QCA. Receiver-operating characteristic analysis demonstrated that quantification of DS severity improved the diagnostic accuracy of MDCT (area under curve [AUC] 0.81 vs. 0.92, p < 0.001) but not that of MR (AUC 0.78 vs. 0.83, p = NS).

Conclusions

Visual assessment of coronary diameter stenosis severity by MR or MDCT allows identification of significant coronary artery disease with a similar high diagnostic accuracy. Quantitative analysis significantly further improves the diagnostic accuracy of MDCT but not that of MR.

Abbreviations and Acronyms

CNR
contrast-to-noise ratio
CT
computed tomography
DS
diameter stenosis
LAD
left anterior descending coronary artery
LCx
left circumflex coronary artery
LM
left main coronary artery
MDCT
multidetector row computed tomography
MLD
minimal luminal diameter
MRI
magnetic resonance imaging
QCA
quantitative coronary angiography
RCA
right coronary artery
RVD
reference vessel diameter

Cited by (0)

1

Dr. Gerber was supported by a grant from the Fondation de la Recherche Scientifique of the Belgian Government (FRSM 3.4557.02).

2

Dr. Legros was supported by the Centre Hospitalier de Schaffner de Lens (France).