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MR coronary angiography with SH L 643 A: initial experience in patients with coronary artery disease
Christoph U Herborn1, Michaela Schmidt, Oliver Bruder
1Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany.
Insights
The new contrast agent SH L 643 A significantly improved image quality and detection of coronary artery disease in three-dimensional MR coronary angiography. This enhancement led to a decrease in nondiagnostic segments, improving overall accuracy for diagnosing coronary artery disease.
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Radiology
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate imaging techniques.
- Magnetic resonance (MR) coronary angiography offers a non-invasive approach to visualize coronary arteries.
- Improving the accuracy and image quality of MR coronary angiography is crucial for effective patient management.
Purpose of the Study:
- To prospectively evaluate the diagnostic accuracy of breath-hold 3D MR coronary angiography.
- To assess the impact of the intravascular contrast agent SH L 643 A on image quality and CAD detection.
- To determine the sensitivity, specificity, and accuracy of contrast-enhanced MR coronary angiography for CAD.
Main Methods:
- Twelve patients with confirmed coronary artery disease underwent 3D MR coronary angiography before and after SH L 643 A administration.
- Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured.
- Image quality was rated, and coronary segments were evaluated for diagnostic quality and CAD presence by blinded readers.
Main Results:
- SH L 643 A significantly improved CNR (9.8 to 23.0; P < .01) and image quality (2.0 to 2.9; P < .03).
- The proportion of nondiagnostic segments decreased from 38% to 10%.
- Contrast-enhanced MR coronary angiography demonstrated 80% sensitivity, 93% specificity, and 87% accuracy for CAD detection.
Conclusions:
- The intravascular contrast agent SH L 643 A enhances image quality in 3D MR coronary angiography.
- Improved image quality translates to better detection and diagnosis of coronary artery disease.
- SH L 643 A is a valuable tool for improving MR coronary angiography accuracy.
Purpose:
To prospectively assess the accuracy of breath-hold three-dimensional magnetic resonance (MR) coronary angiography with the gadolinium-based intravascular contrast agent SH L 643 A in patients with coronary artery disease.
Materials And Methods:
Twelve patients (seven men, five women; age range, 46-78 years; mean age, 61.3 years) with angiographically proved coronary artery disease (luminal narrowing >50%) underwent breath-hold three-dimensional MR coronary angiography before and after injection of SH L 643 A (0.1 mmol gadolinium per kilogram body weight). For all MR examinations, signal-to-noise ratio and contrast-to-noise ratio were measured. Image quality was assessed with a four-point scale. Conventional angiograms and MR angiograms were evaluated for depiction of the left main, proximal and middle left anterior descending, proximal left circumflex, and proximal and middle right coronary artery segments in a blinded fashion by two experienced readers in consensus. Results of this evaluation were compared by using a paired Student t test. P < .05 was considered to indicate a statistically significant difference.
Results:
For the 72 coronary artery segments, the contrast-to-noise ratio significantly improved after administration of SH L 643 A, compared with the prior ratio (9.8 +/- 5.1 [standard deviation] vs 23.0 +/- 8.7; P < .01), whereas the difference in signal-to-noise ratio did not reach statistical significance (25.2 +/- 11.4 vs 29.5 +/- 9.8; P > .3). Image quality significantly improved from a mean of 2.0 +/- 0.9 for nonenhanced images to 2.9 +/- 0.9 (P < .03) for contrast material-enhanced images. The proportion of segments for which images were nondiagnostic decreased from 38% to 10% with application of SH L 643 A. Overall sensitivity and specificity of contrast-enhanced MR coronary angiography for detection of coronary artery disease were 80% and 93%, respectively, and accuracy was 87%.
Conclusion:
Use of SH L 643 A improves detection of coronary artery disease at three-dimensional MR coronary angiography.
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