A Prospective Study for Comparison of MR and CT Imaging for Detection of Coronary Artery Stenosis

• Published in: JACC. Cardiovascular imaging Vol. 4; no. 1; pp. 50 - 61
• Main Authors: Hamdan, Ashraf, Asbach, Patrick, Wellnhofer, Ernst, Klein, Christoph, Gebker, Rolf, Kelle, Sebastian, Kilian, Harald, Huppertz, Alexander, Fleck, Eckart
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2011
• Subjects: 3.0-T MRI; Aged; Aged, 80 and over; Cardiovascular; Coronary Angiography; Coronary Stenosis - diagnosis; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - therapy; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Myocardial Revascularization; Predictive Value of Tests; Sensitivity and Specificity; Tomography, X-Ray Computed; LCX; MRI; CAD; ROC; ECG; LAD; AUC; CT; 3D; RCA; SNR; 3.0-T MRI; SENSE; coronary angiography; coronary artery disease; magnetic resonance imaging; left anterior descending coronary artery; receiver-operator characteristic; electrocardiogram; 3-dimensional; computed tomography; area under the curve; right coronary artery; sensitivity encoding; left circumflex coronary artery; signal-to-noise ratio
• DOI: 10.1016/j.jcmg.2010.10.007
• ISSN: 1936-878X; 1876-7591

The purpose of the present study was to directly compare the diagnostic accuracy of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the detection of coronary artery stenosis. Both imaging modalities have emerged as potential noninvasive coronary imaging modalities; however, CT—unlike MRI—exposes patients to radiation and iodinated contrast agent. One hundred twenty consecutive patients with suspected or known coronary artery disease prospectively underwent 32-channel 3.0-T MRI and 64-slice CT before elective X-ray angiography. The diagnostic accuracy of the 2 modalities for detecting significant coronary stenosis (≥50% luminal diameter stenosis) in segments ≥1.5 mm diameter was compared with quantitative invasive coronary angiography as the reference standard. In the patient-based analysis MRI and CT angiography showed similar diagnostic accuracy of 83% (95% confidence interval [CI]: 75 to 87) versus 87% (95% CI: 80 to 92), p = 0.38; sensitivity of 87% (95% CI: 76 to 93) versus 90% (95% CI: 80 to 95), p = 0.16; and specificity of 77% (95% CI: 63 to 87) versus 83% (95% CI: 70 to 91), p = 0.06, respectively. All cases of left main or 3-vessel disease were correctly diagnosed by MRI and CT angiography. In the patient-based analysis MRI and CT angiography were similar in their ability to identify patients who subsequently underwent revascularization: the area under the receiver-operator characteristic curve was 0.78 (95% CI: 0.69 to 0.87) for MRI and 0.82 (95% CI: 0.74 to 0.90) for CT angiography. Thirty-two channel 3.0-T MRI and 64-slice CT angiography similarly identify significant coronary stenosis in patients with suspected or known coronary artery disease scheduled for elective coronary angiography. However, CT angiography showed a favorable trend toward higher diagnostic performance.