Correlation between magnetic resonance angiography (MRA) and quantitative coronary angiography (QCA) in ectatic
Sophie I Mavrogeni1, Athanassios Manginas, Emmanouil Papadakis
1Onassis Cardiac Surgery Center, Athens, Greece. soma@aias.gr
Insights
Magnetic resonance angiography (MRA) accurately measures coronary artery ectasia (CAE) diameters, correlating closely with quantitative coronary angiography (QCA). This noninvasive MRA technique offers a valuable alternative for efficient patient follow-up, reducing the need for repeat invasive procedures.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary artery ectasia (CAE) involves arterial dilatation, requiring accurate monitoring.
- Current follow-up methods rely on repeat angiograms, which are invasive.
- Noninvasive imaging modalities are needed for efficient CAE management.
Purpose of the Study:
- To compare quantitative coronary angiography (QCA) with magnetic resonance angiography (MRA) for measuring coronary artery ectasia.
- To evaluate the accuracy of MRA in detecting and quantifying CAE.
- To assess MRA's potential as a noninvasive tool for CAE follow-up.
Main Methods:
- Fifteen patients with known CAE underwent both QCA and ECG-triggered MRA.
- MRA utilized both white-blood (WB) and black-blood (BB) contrast sequences.
- Correlations between QCA and MRA diameter measurements were analyzed.
Main Results:
- MRA provided continuous visualization of major coronary arteries.
- No significant differences were found between WB and BB MRA measurements.
- MRA showed a strong correlation (r=0.87, p<0.001) with QCA, with no systematic bias.
Conclusions:
- Coronary MRA demonstrates high accuracy and close correlation with QCA for CAE detection.
- Noninvasive MRA is a valuable tool for efficient follow-up of patients with coronary artery ectasia.
- MRA can potentially replace or reduce the need for repeat invasive angiograms.
Abstract:
Coronary artery ectasia (CAE) is defined as a dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal artery. The correct follow-up of ectatic vessels is hampered by the need for repeat angiograms. In this work we compared quantitative coronary angiography (QCA) measurements of the diameter of the proximal most ectatic part of coronary vessels, with corresponding measurements obtained by magnetic resonance angiography (MRA) using both gradient echo and turbo spin echo imaging sequences. Fifteen patients (14 male), aged 45-65 years, with known CAE were prospectively studied. Two electrocardiogram (ECG)-triggered pulse sequences were implemented for coronary magnetic resonance angiography. The first was a three-dimensional (3D), segmented, k-space gradient-echo sequence, employing a T2-weighted preparation prepulse and a frequency-selective, fat-saturation prepulse to enhance "white blood" (WB) contrast of the coronary arteries. The second sequence was an M2D dual Inversion Recovery (IR) Turbo Spin-Echo with a linear k-space acquisition scheme, providing "black-blood" (BB) contrast of the coronaries. All scans were carried out with the patient free breathing using a 2D, real-time Navigator beam, for respiratory motion tracking and gating. All patients underwent QCA, and the diameter of the proximal most ectatic part of each vessel was measured and compared with "white-blood" and "black-blood" MRA measurements. The average length of continuously visualized LM, LAD, LCx, and RCA by MRA was 2.5 +/- 0.3, 5.8 +/- 0.8, 3.9 +/- 1.0, and 7.2 +/- 1.2 cm, respectively. There were no statistically significant differences between diameter measurements of the proximal most ectatic part of each vessel, obtained with WB and BB sequences. There was a close correlation between MRA and QCA measurements (r = 0.87, p < 0.001). Bland-Altman analysis showed no systematic differences between the examined methods, over the whole range of vessel diameters measured. Coronary MRA is in close correlation with QCA for CAE detection. Magnetic resonance angiography, being noninvasive, may prove of significant value for the efficient follow-up of these patients.
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