Head-to-head comparison of three-dimensional navigator-gated magnetic resonance imaging and 16-slice computed tomography to detect coronary artery stenosis in patients.

Kefer, Joëlle;Coche, Emmanuel;Legros, Gabin;Pasquet, Agnes;Gerber, Bernhard;et.al.
(2005) Journal of the american college of cardiology : JACC — Vol. 46, n° 1, p. 92-100 (2005)

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Abstract
OBJECTIVES: The purpose of this research was to compare the diagnostic accuracy of three-dimensional navigator-gated magnetic resonance (MR) imaging and 16-slice multidetector row computed tomography (MDCT) versus quantitative coronary angiography (QCA) for the detection of coronary artery stenosis in patients. BACKGROUND: Both MR and MDCT are novel non-invasive tests, which have been proposed for noninvasive detection of coronary artery disease. Yet their diagnostic accuracy has not been directly compared in the same population. METHODS: Fifty-two patients underwent coronary MR and 16-slice MDCT before invasive coronary angiography. Diameter stenosis (DS) severity in vessels >1.5-mm reference diameter were graded visually and measured quantitatively on both MR and MDCT images. Diagnostic accuracy of both methods was compared using QCA as the reference test. RESULTS: According to QCA, 81 of 452 (18%) coronary segments with >1.5 mm diameter had >50% DS. By visual analysis, MR and MDCT had similar sensitivity (75% vs. 82%, p = NS), specificity (77% vs. 79%, p = NS), and diagnostic accuracy (77%, vs. 80%, p = NS) for detection of >50 % DS. Quantitative measures of DS by MR (r = 0.60, p < 0.001) and MDCT (r = 0.75, both p < 0.001) correlated well with QCA. Receiver-operating characteristic analysis demonstrated that quantification of DS severity improved the diagnostic accuracy of MDCT (area under curve [AUC] 0.81 vs. 0.92, p < 0.001) but not that of MR (AUC 0.78 vs. 0.83, p = NS). CONCLUSIONS: Visual assessment of coronary diameter stenosis severity by MR or MDCT allows identification of significant coronary artery disease with a similar high diagnostic accuracy. Quantitative analysis significantly further improves the diagnostic accuracy of MDCT but not that of MR.
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Kefer, J., Coche, E., Legros, G., Pasquet, A., Grandin, C., Van Beers, B., Vanoverschelde, J.-L., & Gerber, B. (2005). Head-to-head comparison of three-dimensional navigator-gated magnetic resonance imaging and 16-slice computed tomography to detect coronary artery stenosis in patients. Journal of the american college of cardiology : JACC, 46(1), 92-100. https://doi.org/10.1016/j.jacc.2005.03.057 (Original work published 2005)