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

https://doi.org/10.1016/j.jcmg.2010.10.007Get rights and content
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Objectives

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.

Background

Both imaging modalities have emerged as potential noninvasive coronary imaging modalities; however, CT—unlike MRI—exposes patients to radiation and iodinated contrast agent.

Methods

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.

Results

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.

Conclusions

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.

Key Words

3.0-T MRI
coronary angiography
CT

Abbreviations and Acronyms

3D
3-dimensional
AUC
area under the curve
CAD
coronary artery disease
CT
computed tomography
ECG
electrocardiogram
LAD
left anterior descending coronary artery
LCX
left circumflex coronary artery
MRI
magnetic resonance imaging
RCA
right coronary artery
ROC
receiver-operator characteristic
SENSE
sensitivity encoding
SNR
signal-to-noise ratio

Cited by (0)

The study was supported by the Foundation Deutsches Herzzentrum Berlin. Dr. Hamdan has received a grant from the European Society of Cardiology Working group for Cardiovascular Magnetic Resonance. All other authors report that they have no relationships to disclose.