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  • Title: Noninvasive detection of coronary artery stenosis using contrast-enhanced three-dimensional breath-hold magnetic resonance coronary angiography.
    Author: Regenfus M, Ropers D, Achenbach S, Kessler W, Laub G, Daniel WG, Moshage W.
    Journal: J Am Coll Cardiol; 2000 Jul; 36(1):44-50. PubMed ID: 10898411.
    Abstract:
    OBJECTIVES: The purpose of this study was to evaluate a contrast-enhanced three-dimensional (3D) breath-hold magnetic resonance (MR) technique for detection of coronary artery stenoses. BACKGROUND: The accuracy of previously published MR coronary angiography protocols varies widely. Recently, coronary artery imaging using T1-shortening contrast agent has become possible, but so far there are no data concerning its clinical application. METHODS: Magnetic resonance coronary angiography was performed in 50 patients with suspected coronary artery disease. Magnetic resonance data acquisition using an ultrafast 3D gradient-echo sequence lasted over 32 heartbeats within one single breath-hold. Twenty milliliters of gadopentetate dimeglumine was injected at a flow rate of 1 ml/s for two successive studies covering the main coronary arteries in single-oblique planes. Stenosis assessment by MR was compared with significant (diameter stenosis > 50%) stenoses on X-ray angiography. Evaluation was limited to the proximal and mid-coronary artery segments. RESULTS: Two hundred sixty-eight of 350 artery segments (76.6%) could be evaluated. Left circumflex coronary artery was only evaluable in 50% of cases by MR. In the evaluable segments, 48 of 56 stenoses and 193 of 212 nonstenotic segments were correctly classified by MR. On a patient basis, MR correctly identified 34 of 36 patients with and 8 of 14 patients without significant coronary stenoses as demonstrated by X-ray angiography (sensitivity 94.4%, specificity 57.1%). CONCLUSIONS: Oblique projection contrast-enhanced MR coronary angiograms obtained within one single breath-hold permit identification of patients with coronary stenoses in the proximal and mid segments of the major coronary arteries with satisfactory accuracy.
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