Purpose: To prospectively evaluate the accuracy of contrast-enhanced whole-heart coronary magnetic resonance angiography (CMRA) at 3.0 T, with the use of sublingual nitroglycerin and abdominal banding, for assessing significant stenosis (≧50% lumen diameter reduction) in patients with suspected coronary disease, using conventional coronary artery angiography as the reference standard. Methods: We prospectively studied 71 consecutive patients with suspected coronary artery disease scheduled for conventional coronary angiography. Contrast-enhanced whole-heart CMRA was performed after sublingual nitroglycerin with an abdominal banding rolled tightly along the side of the ribs. The diagnostic performance of CMRA for the detection of significant lesions was compared with that of quantitative coronary angiography. Results: The acquisition of CMRA was completed in 67 of 71 patients, with an average imaging time of 9.6 ± 3.2 min. The average navigator efficiency was 48%. The sensitivity, specificity as well as positive and negative predictive values of whole-heart CMRA for the detection of significant lesions on a segment-by-segment analysis were 91.4, 85.8, 48.7 and 98.5%, respectively, and in a patient-based analysis 94.6, 86.7, 89.7 and 92.9%, respectively. Conclusions: Contrast-enhanced whole-heart CMRA with 3.0 T optimized by using sublingual nitroglycerin and abdominal banding methods permits reliable detection of significant obstructive coronary artery disease in patients with suspected coronary disease.

1.
2001 Heart and Stroke Statistical Update. Dallas, American Heart Association, 2000.
2.
Agostoni P, Biondi-Zoccai GG, de Benedictis ML, et al: Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures: systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol 2004;44:349–356.
3.
Paulin S, von Schulthess GK, Fossel E, Krayenbuehl HP: MR imaging of the aortic root and proximal coronary arteries. AJR Am J Roentgenol 1987;148:665–670.
4.
McConnell MV, Khasgiwala VC, Savord BJ, Chen MH, Chuang ML, Edelman RR, Manning WJ: Prospective adaptive navigator correction for breath-hold MR coronary angiography. Magn Reson Med 1997;37:148–152.
5.
Danias PG, McConnell MV, Khasgiwala VC, Chuang ML, Edelman RR, Manning WJ: Prospective navigator correction of image position for coronary MR angiography. Radiology 1997;203:733–736.
6.
Stuber M, Botnar RM, Danias PG, Kissinger KV, Manning WJ: Submillimeter three-dimensional coronary MR angiography with real-time navigator correction: comparison of navigator locations. Radiology 1999;212:579–587.
7.
Pruessmann KP, Weiger M, Scheidegger MB, Boesiger P: SENSE: sensitivity encoding for fast MRI. Magn Reson Med 1999;42:952–962.
8.
Griswold MA, Jakob PM, Heidemann RM, et al: Generalized autocalibrating partially parallel acquisitions (GRAPPA). Magn Reson Med 2002;47:1202–1210.
9.
Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E, et al: Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med 2001;345:1863–1869.
10.
Sakuma H, Ichikawa Y, Chino S, Hirano T, Makino K, Takeda K: Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography. J Am Coll Cardiol 2006;48:1946–1950.
11.
Bi X, Carr JC, Li D: Whole-heart coronary magnetic resonance angiography at 3 tesla in 5 minutes with slow infusion of Gd-BOPTA, a high-relaxivity clinical contrast agent. Magn Reson Med 2007;58:1–7.
12.
Liu X, Bi X, Huang J, Jerecic R, Carr J, Li D: Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0 T: comparison with steady-state free precession technique at 1.5 T. Invest Radiol 2008;43:663–668.
13.
Yang Q, Li K, Liu X, et al: Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0-T: a comparative study with X-ray angiography in a single center. J Am Coll Cardiol 2009;54:69–76.
14.
Weber OM, Martin AJ, Higgins CB: Whole-heart steady-state free precession coronary artery magnetic resonance angiography. Magn Reson Med 2003;50:1223–1228.
15.
Aharon S, Oksuz O, Lorenz C: Simultaneous projection of multibranched vessels with their surroundings on a single image from coronary MRA; in Proceedings of the 14th Annual Meeting of ISMRM, Seattle, Wash., ISMRM, 2006, abstract 365.
16.
Dewey M, Teige F, Schnapauff D, et al: Noninvasive detection of coronary artery stenoses with multislice computed tomography or magnetic resonance imaging. Ann Intern Med 2006;145:407–415.
17.
Sakuma H, Ichikawa Y, Suzawa N, Hirano T, Makino K, Koyama N, Van Cauteren M, Takeda K: Assessment of coronary arteries with total study time of less than 30 minutes by using whole-heart coronary MR angiography. Radiology 2005;237:316–321.
18.
Terashima M, Meyer CH, Keeffe BG, et al: Noninvasive assessment of coronary vasodilation using magnetic resonance angiography. J Am Coll Cardiol 2005;45:104–110.
19.
Li D, Carr JC, Shea SM, Zheng J, Deshpande VS, Wielopolski PA, Finn JP: Coronary arteries: magnetization-prepared contrast-enhanced three-dimensional volume-targeted breath-hold MR angiography. Radiology 2001;219:270–277.
20.
Paetsch I, Jahnke C, Barkhausen J, Spuentrup E, Cavagna F, Schnackenburg B, Huber M, Stuber M, Fleck E, Nagel E: Detection of coronary stenoses with contrast enhanced, three-dimensional free breathing coronary MR angiography using the gadolinium-based intravascular contrast agent gadocoletic acid (B-22956). J Cardiovasc Magn Reson 2006;8:509–516.
21.
Stuber M, Botnar RM, Danias PG, McConnell MV, Kissinger KV, Yucel EK, Manning WJ: Contrast agent-enhanced, free-breathing, three-dimensional coronary magnetic resonance angiography. J Magn Reson Imaging 1999;10:790–799.
22.
Bi X, Deshpande V, Simonetti O, Laub G, Li D: Three-dimensional breathhold SSFP coronary MRA: a comparison between 1.5T and 3.0T. J Magn Reson Imaging 2005;22:206–212.
23.
Sommer T, Hackenbroch M, Hofer U, Schmiedel A, Willinek WA, Flacke S, Gieseke J, Traber F, Fimmers R, Litt H, Schild H: Coronary MR angiography at 3.0 T versus that at 1.5 T: initial results in patients suspected of having coronary artery disease. Radiology 2005;234:718–725.
24.
Stuber M, Botnar RM, Fischer SE, Lamerichs R, Smink J, Harvey P, Manning WJ: Preliminary report on in vivo coronary MRA at 3 Tesla in humans. Magn Reson Med 2002;48:425–429.
25.
McCarthy RM, Desphande VS, Beohar N, et al: Three-dimensional breathhold magnetization-prepared TrueFISP: a pilot study for magnetic resonance imaging of the coronary artery disease. Invest Radiol 2007;42:665–670.
26.
Finn JP, Nael K, Deshpande V, et al: Cardiac MR imaging: state of the technology. Radiology 2006;241:338–354.
27.
Schar M, Kozerke S, Fischer SE, et al: Cardiac SSFP imaging at 3 Tesla. Magn Reson Med 2004;51:799–806.
28.
Deshpande VS, Shea SM, Li D: Artifact reduction in true-FISP imaging of the coronary arteries by adjusting imaging frequency. Magn Reson Med 2003;49:803–809.
29.
Hoffmann U, Moselewski F, Cury RC, Ferencik M, Jang IK, Diaz LJ, Abbara S, Brady TJ, Achenbach S: Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient-versus segment-based analysis. Circulation 2004;110:2638–2643.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.