Abstract:
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Purpose: To evaluate the safety and the efficacy of an intravascular
contrast agent (Gadomer; Schering AG, Berlin Germany) for breathhold magnetic
resonance coronary angiography (MRCA) and to compare the image quality and the
the diagnostic accurracy with a steady state free precession technique.
Methods and Materials: 12 patients with angiographically proven coronary artery
disease underwent breathhold MRCA on a 1.5 T scanner (Magnetom Sonata, Siemens,
Erlangen Germany). Unenhanced MRCA was performed with a 3D steady-state free
precession (SSFP) sequence (TR 3.8ms, TE 1.6ms, FA 65°, Matrix 512). Following
the administration an intravascular contrast agent (Gadomer, 0.1mmol/kg)
multiple breathhold 3D data sets of the right and left coronary artery were obtained
using an inversion recovery turboFLASH sequence (TR 5.8ms, TE 2.2ms, FA 25°,
Matrix 512). SNR and CNR were calculated from ROIs within the vessel lumen and
the myocardium. Image quality was assessed on a 4-point scale (1
non-diagnostic, 2 moderate, 3 good, 4 excellent). Catheter angiography and MRCA
were compared on a segment basis for the main coronary artery, the proximal and
middle LAD, the proximal CX as well as the proximal and middle RCA resulting in
a total of 72 segments.
Results: Intravenous administration of Gadomer was well tolerated by all
patients. The overall image quality significantly improved from 2.0±0.9 to 2.9±0.9
on the contrast enhanced scans, and the number of non-diagnostic segments
significantly decreased from 38% to 10%. Compared to the SSFP sequence the SNR
only slightly increased (p>0.05), but the CNR of blood and myocardium
significantly improved form 9.8±9.1 to
31±8.7 for the Gadomer enhanced images
(p<0.05). Compared with conventional catheter angiography contrast-enhanced
MRCA had a sensitivity of 80% and a specificity of 93% for the detection of
substantial stenoses (>70%), whereas the SSFP technique showed a sensitivity
of 63% and a specificity of 96%.
Conclusion: Gadomer significantly improves image quality and diagnostic
accuracy of 3D breathhold MRCA and mandates further clinical evaluation in a
larger patient cohort with coronary artery disease.
(K.S. is an employee of Schering AG.)
Questions about this event email: joerg.barkhausen@uni-essen.de
Barkhausen MD, J,
Comparison of Steady-State-Free Precession and Gadomer-enhanced MR Coronary Angiography in Patients with Known Coronary Artery Disease. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103709.html
