Breath-hold 3D steady-state free precession coronary MRA compared with conventional X-ray coronary angiography

To evaluate the use of breath-hold three-dimensional (3D) steady-state free precession (SSFP) coronary magnetic resonance angiography (MRA) in patients with coronary artery disease (CAD) in comparison with conventional coronary x-ray angiography (XRA).

Twenty-eight patients with suspected CAD were examined with the use of a breath-hold 3D-SSFP-MRA sequence and conventional XRA. To assess the accuracy of MRA, two clinicians who were blinded to patient information independently reviewed the MRA and XRA data, which were presented in a randomized order. To identify discrepancies between MRA and XRA, and assess features of coronary lesions on MRA, two additional clinicians examined MRA and XRA data that were presented side by side, divided into proximal, mid, and distal segments, and compared them segment by segment.

The sensitivity and specificity for diagnosing significant coronary stenoses (> 50% diameter narrowing) were 64% and 94%, respectively. At sites of coronary lesions identified on XRA, bright signals and enlarged vessel profiles, in addition to the characteristic narrow lumen, were frequently observed on MRA.

Breath-hold SSFP coronary MRA has good specificity but inconclusive sensitivity in diagnosing significant coronary stenoses, and provides important image features for depicting coronary lesions.