3D non-contrast whole‑heart coronary MR angiography at 3 T with compressed sensing in elderly patients: Optimization...

Coronary magnetic resonance angiography (CMRA) is increasingly used in clinical practice, but lengthy scan times can be challenging for elderly patients. This study evaluates the impact of compressed sensing (CS) technology on image quality and diagnostic performance of 3 T CMRA in elderly patients, aiming to identify the optimal acceleration factor.

We prospectively enrolled elderly individuals who underwent coronary computed tomography angiography (CCTA) from June to November 2023 for non-contrast whole-heart CMRA with CS acceleration factors of 4, 6, or 8. Elderly volunteers rated their experiences with the optimal acceleration factor. Image quality and diagnostic performance were analyzed using a general linear model and the area under the receiver operating characteristic curves (AUC), with CCTA as the reference standard.

Sixty-seven individuals (34 men, mean age 74.3 ± 7.2 years) were enrolled. Scan times significantly decreased from 578.6 ± 131.4 s to 366.1 ± 91.2 s and 261.1 ± 76.5 s for acceleration factors 4, 6, and 8, respectively. Subjective image quality scores, signal-to-noise ratio, and contrast-to-noise ratio were significantly better with CS4 and CS6 than with CS8. Diagnostic performance declined with increasing acceleration, with sensitivities of 92.2 %, 88.0 %, and 72.5 %, and specificities of 94.1 %, 92.6 %, and 85.3 % for CS4, CS6, and CS8, respectively. CS6 was determined to be the optimal acceleration factor. Volunteers reported that CS6 was more acceptable than CS4.

CMRA with CS6 provides rapid scanning while maintaining adequate diagnostic performance, making it a reliable alternative to CCTA for diagnosing coronary artery disease in elderly patients.