Abstract 2333: Coronary Magnetic Resonance Angiography with Whole Heart Coverage for The Detection of Coronary Arery Stenoses: A Multicenter Study

Abstract

Background: Previous single center studies demonstrated that coronary magnetic resonance angiography (MRA) with whole heart coverage allows for noninvasive detection of coronary artery disease. In this prospective, multicenter study, we investigated the accuracy of whole heart coronary MRA in patients with suspected coronary disease. Methods: The subjects were recruited from five institutions. Free-breathing coronary MRA covering the entire heart were obtained in fifty eight patients by using a 3-dimensional, segmented steady-state free precession sequence without contrast injection. Coronary MRA was interpreted by 3 independent observers. Conventional X-ray coronary angiography was analyzed by a separate blinded reviewer. The diagnostic accuracy of coronary MRA was determined in all segments with reference diameter of 2 mm or more on X-ray coronary angiography regardless of the image quality of MRA. Results: Acquisition of coronary MRA was completed in all patients with an averaged imaging time of 9.8 ± 4.8 min. On patient based analysis, coronary MRA showed the sensitivity of 79.4% (range 64.7–88.2%), the specificity of 70.1% (65.9–80.5%), and the negative predictive value of 89.6% (84.6–93.1%). The sensitivity, specificity and negative predictive value in the segmental analysis were 60.6% (53.8–65.4%), 95.5% (94.2–97.6%) and 97.7% (97.4–98.1%). Conclusions: Coronary MRA with whole heart coverage can provide detection of luminal narrowing of the coronary artery with moderate sensitivity, high specificity and high negative predictive value. The high negative predictive value observed in this multicenter study indicates that noninvasive MRA approach is useful in ruling out significant coronary artery disease.