Published Online
on July 30, 2008

A more recent version of this article appeared on September 1, 2008

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Original Article

Direct Comparison of Whole-Heart Navigator Gated Magnetic Resonance Coronary Angiography and 40/64 Slice Multi Detector Row Computed Tomography to detect Coronary Artery Stenosis in Patients Scheduled for Conventional Coronary Angiography.

Anne-Catherine Pouleur; Jean-Benoît le Polain de Waroux; Joelle Kefer; Agnès Pasquet; Jean-Louis J. Vanoverschelde and Bernhard L Gerber¹

Division of Cardiology, Cliniques Universitaires St. Luc UCL

¹ E-mail: bernhard.gerber{at}clin.ucl.ac.be

Background—Both whole-heart magnetic resonance coronary angiography (WH-MRCA) and multidetector CT (MDCT) have been proposed for non-invasive identification of coronary stenosis. We sought to directly compare the diagnostic accuracy of these non-invasive imaging techniques using invasive quantitative coronary angiography (QCA) as reference standard.

Methods and Results—Seventy-seven consecutive patients (56 male, 61±14 years) prospectively underwent WH-MRCA and 40/64-slice MDCT before QCA. Diagnostic accuracy of WH-MRCA and MDCT for visual identification of >50% diameter stenosis (DS) in segments >1.5 mm size was compared using QCA as reference. According to QCA, 49 of 992 coronary segments >1.5 mm diameter had >50% DS. MDCT had higher success rate (100% vs. 88%, p<0.001) and allowed to identify more segments (963 vs. 726, p<0.001) than WH-MRCA. On a per segment basis, WH-MRCA had similar sensitivity (47/49 or 96% vs. 48/49 or 98%, p=0.9), but significantly lower specificity (644/943 or 68% vs. 863/943 or 92%, p<0.001) and accuracy (691/992 or 70% vs. 911/992 or 92%, p<0.001) for detection of >50% DS than MDCT. On a per patient basis, the sensitivity was similar (17/17 or 100% vs. 16/17 or 94%, p=0.9), but specificity (43/60 or 72% vs. 53/60 or 88%, p=0.024) and diagnostic accuracy (60/77 or 78%, vs. 69/77 or 90%, p=0.044) of WH-MRCA for detection of >50% DS were significantly lower than of MDCT.

Conclusion—Because of higher success rate and higher number of interpretable segments, 40/64 slice MDCT performs better than WH-MRCA.

Key Words: contrast media • coronary disease • magnetic resonance imaging • computed tomography

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Pim J. de Feyter and Robert-Jan van Geuns
Circ Cardiovasc Imaging 2008 1: 89-91. [Extract] [Full Text] [PDF]

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