Diagnostic Efficacy of Coronary Artery Three-Dimensional Steady-State Free Precession Magnetic Resonance Angiography in Comparison with Invasive Coronary Angiography for Detecting Coronary Artery Disease.

ABSTRACT

PURPOSE: To assess the diagnostic value of three-dimensional steady-state free precession magnetic resonance angiography (3D-SSFP MRA) for detecting coronary artery disease (CAD). MATERIALS AND METHODS: Patients suspected of CAD based on clinical evaluation, underwent invasive coronary angiography (CAG) and Cardiac MRA (CMRA). Collected data in favor of any CAD findings in CMRA were compared to CAG results as the standard diagnostic method in CAD detection. Analysis was performed on per-patient, per-vessel and per-segment bases. RESULTS: A total of 30 patients (mean age 43 ± 10 years, 19 men) were enrolled for analysis. On per-patient analysis, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under receiver operator characteristic (ROC) curve of CMRA for detection of coronary artery stenosis were 100% (CI95% 75% - 100%), 50% (CI95% 18% - 81%), 73.33% (CI95% 46% - 90%), 100% (CI95% 47% - 100%) and 0.827, respectively. On per-vessel analysis, CMRA had a sensitivity of 89.29% (CI95% 71%-97%), specificity of 80.56% (CI95% 63% - 91%), PPV of 78.13% (CI95% 60% - 90%), NPV of 90.63% (CI95% 74% - 98%) and area under ROC curve of 0.845. On per-segment analysis, sensitivity, specificity, PPV and NPV of CMRA for segmental stenosis detection were 77.78% (CI95% 60% - 89%), 87% (CI95% 81% - 92%), 62% (CI95% 46% - 76%), and 93.89% (CI95%  88% - 97%), respectively. Area under ROC curve was 0.835 on per-segment analysis. CONCLUSION: 3D SSFP CMRA provides a promising non-invasive diagnostic tool for assessing coronary artery disease.