A prospective study for comparison of MR and CT imaging for detection of coronary artery stenosis

Ashraf Hamdan*, Patrick Asbach, Ernst Wellnhofer, Christoph Klein, Rolf Gebker, Sebastian Kelle, Harald Kilian, Alexander Huppertz, Eckart Fleck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The purpose of the present study was to directly compare the diagnostic accuracy of magnetic resonance imaging (MRI) and multislice computed tomography (CT) for the detection of coronary artery stenosis. Background Both imaging modalities have emerged as potential noninvasive coronary imaging modalities; however, CTunlike MRIexposes patients to radiation and iodinated contrast agent. Methods One hundred twenty consecutive patients with suspected or known coronary artery disease prospectively underwent 32-channel 3.0-T MRI and 64-slice CT before elective X-ray angiography. The diagnostic accuracy of the 2 modalities for detecting significant coronary stenosis (<50% luminal diameter stenosis) in segments <1.5 mm diameter was compared with quantitative invasive coronary angiography as the reference standard. Results In the patient-based analysis MRI and CT angiography showed similar diagnostic accuracy of 83% (95% confidence interval [CI]: 75 to 87) versus 87% (95% CI: 80 to 92), p = 0.38; sensitivity of 87% (95% CI: 76 to 93) versus 90% (95% CI: 80 to 95), p = 0.16; and specificity of 77% (95% CI: 63 to 87) versus 83% (95% CI: 70 to 91), p = 0.06, respectively. All cases of left main or 3-vessel disease were correctly diagnosed by MRI and CT angiography. In the patient-based analysis MRI and CT angiography were similar in their ability to identify patients who subsequently underwent revascularization: the area under the receiver-operator characteristic curve was 0.78 (95% CI: 0.69 to 0.87) for MRI and 0.82 (95% CI: 0.74 to 0.90) for CT angiography. Conclusions Thirty-two channel 3.0-T MRI and 64-slice CT angiography similarly identify significant coronary stenosis in patients with suspected or known coronary artery disease scheduled for elective coronary angiography. However, CT angiography showed a favorable trend toward higher diagnostic performance.

Original languageEnglish
Pages (from-to)50-61
Number of pages12
JournalJACC: Cardiovascular Imaging
Volume4
Issue number1
DOIs
StatePublished - Jan 2011

Funding

FundersFunder number
Foundation Deutsches Herzzentrum Berlin
European Society of Cardiology

    Keywords

    • 3.0-T MRI
    • CT
    • coronary angiography

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