Contrast enhanced coronary MRA at 3.0 T using a 32 channel coil to detect coronary artery stenosis - how does it measure up against 64-slice coronary CTA and X-ray angiography?

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Materials and methods 32 patients with suspected CAD who were scheduled for CAG underwent both coronary MRA and coronary CTA. 3.0 T contrast enhanced whole-heart coronary MRA was acquired by using an ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence and 32 channel coils was used with GRAPPA factor of 3. Coronary CTA was performed using a 64-Slice CT scanner. For image analysis, standard 15-segment AHA classification system was used. The diagnostic accuracy of MRA and CTA in detecting significant stenoses (≥ 50% of vessel lumen) was compared on the per-segment basis using CAG as reference standard. Results MRA and CTA examinations were successfully completed in all 32 patients. The averaged imaging time of MRA was 6.1 ± 1.2 min. In a total of 419 coronary segments with a reference luminal diameter ≥ 1.5 mm on QCA, forty-nine (12%) on MRA were evaluated as non-assessable and twenty-eight on CTA were non-diagnostic. On the assessable segments basis, 3.0 T whole-heart CMRA correctly identified 45 significant stenoses, and CTA correctly identified 52 significant stenoses. The sensitivity, specificity, PPV and NPV of MRA and CTA for detecting significant stenoses were 92%, 95%, 73%, 99% and 96%, 92%, 67%, 99%, respectively, on assessable segments basis.