Shingo Kato MD, Presenter: Nothing to Disclose

Kakuya Kitagawa MD, Abstract Co-Author: Nothing to Disclose

Motonori Nagata MD, PhD, Abstract Co-Author: Nothing to Disclose

Yeonyee Elizabeth Yoon, Abstract Co-Author: Nothing to Disclose

Masato Yonezawa MD, Abstract Co-Author: Nothing to Disclose

Hajime Sakuma MD, Abstract Co-Author: Nothing to Disclose

Comprehensive cardiac MR (CMR) study at 3T may offer accurate detection of myocardial ischemia and infarction as well as delineation of luminal narrowing in the coronary artery. The purpose of this study was to evaluate the feasibility and diagnostic performance of 3T CMR study including stress and rest myocardial perfusion MRI, late gadolinium enhanced MRI (LGE) and whole-heart coronary MR angiography (CMRA) for the detection of significant coronary artery disease (CAD).

Fifty patients (50±9 years old, 38 men) with suspected CAD who were scheduled for X-ray coronary angiography underwent CMR study by using a 3T MRI with 32 channel cardiac coils. Stress and rest perfusion MR images are acquired with a k-t-SENSE accelerated TFE sequence with B1-insensitive saturation pulse. After acquiring LGE MRI, free-breathing CMRA was obtained by employing a navigator-echo gated 3D TFE sequence with T2 preparation, SPIR fat saturation and SENSE factor of 4. Two observers qualitatively determined presence of myocardial ischemia and luminal narrowing in the coronary arteries on CMR. Significant coronary arterial stenosis was defined as a reduction in luminal diameter of ≥50% on X-ray coronary angiography.

CMR study including CMRA was successfully completed in all patients with an averaged total study time of 67±10 minutes. LGE was observed in 23 (46%) patients. On a patient based analysis, sensitivity, specificity, positive and negative predictive values (PPV and NPV) of stress perfusion MRI for predicting CAD on X-ray angiography were 91% (21/23), 89% (24/27), 88% (21/24) and 92% (24/26). These values by CMRA were 87% (20/23), 93% (25/27), 91% (20/22), 89% (25/28). Combined stress perfusion MRI and CMRA study demonstrated sensitivity of 96% (22/23), specificity of 85% (23/27), PPV of 85% (22/26) and NPV of 96% (23/24).

The results in current study demonstrated that the comprehensive 3T CMR study has high success rate in patients with suspected CAD and allows for noninvasive assessments of myocardial ischemia and luminal narrowing in the coronary arteries. High sensitivity (96%) and high NPV (96%) indicate that 3T comprehensive CMR study can accurately rule out CAD.

3T comprehensive CMR can play a pivotal role in managing patients with suspected CAD since this approach permits assessment of myocardial ischemia in addition to reliable detection of significant CAD.

Kato, S, Kitagawa, K, Nagata, M, Yoon, Y, Yonezawa, M, Sakuma, H, Diagnostic Performance of 3 T Comprehensive Cardiac Magnetic Resonance Study for Detecting Significant Coronary Artery Disease.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010560.html