TY - JOUR
T1 - Whole-heart coronary magnetic resonance angiography at 1.5 tesla
T2 - Does a blood-pool contrast agent improve diagnostic accuracy?
AU - Wagner, Moritz
AU - Rösler, Roberta
AU - Lembcke, Alexander
AU - Butler, Craig
AU - Dewey, Marc
AU - Laule, Michael
AU - Huppertz, Alexander
AU - Schwenke, Carsten
AU - Warmuth, Carsten
AU - Rief, Matthias
AU - Hamm, Bernd
AU - Taupitz, Matthias
PY - 2011/3
Y1 - 2011/3
N2 - Objectives: To evaluate the impact of the blood-pool contrast agent gadofosveset trisodium on diagnostic accuracy of whole-heart coronary magnetic resonance angiography (CMRA) at 1.5 Tesla. Materials and Methods: Thirty consecutive patients with suspected coronary artery disease underwent free-breathing whole-heart CMRA at 1.5 Tesla. CMRA was performed with a T2-prepared steady-state free precession sequence (unenhanced CMRA) and an inversion-recovery-prepared steady-state free precession sequence after administration of gadofosveset trisodium (contrast-enhanced CMRA). Two readers independently performed a per-segment evaluation of CMRA (8 proximal and mid coronary segments) for detection of significant stenosis (50%) using invasive coronary angiography as reference. Disagreement was settled by consensus reading and interobserver variability was assessed using an unweighted kappa statistic. Results: Whole-heart CMRA was successfully performed in 27 patients. The percentage of assessable segments was significantly lower on unenhanced CMRA compared with contrast-enhanced CMRA (Reader 1: 79% [170/216] vs. 89% [192/216], respectively; Reader 2: 73% [157/216] vs. 87% [188/216], respectively; P < 0.001). Intention-to-diagnose analysis of the consensus reading yielded sensitivity, specificity, and diagnostic accuracy of unenhanced versus contrast-enhanced CMRA as follows: 73.1% versus 73.1% (P = 1.0), 68.3% versus 80.2% (P = 0.002), and 68.9% versus 79.3% (P = 0.004), respectively. The kappa value for interobserver agreement was 0.61 (95% confidence interval = 0.50-0.72) for unenhanced CMRA and 0.72 (95% confidence interval = 0.62-0.82) for contrast-enhanced CMRA. CONCLUSIONS:: The blood-pool contrast agent gadofosveset trisodium increased the number of assessable coronary segments on whole-heart CMRA in comparison to unenhanced whole-heart CMRA. The impact of gadofosveset trisodium on diagnostic accuracy, however, was only minor.
AB - Objectives: To evaluate the impact of the blood-pool contrast agent gadofosveset trisodium on diagnostic accuracy of whole-heart coronary magnetic resonance angiography (CMRA) at 1.5 Tesla. Materials and Methods: Thirty consecutive patients with suspected coronary artery disease underwent free-breathing whole-heart CMRA at 1.5 Tesla. CMRA was performed with a T2-prepared steady-state free precession sequence (unenhanced CMRA) and an inversion-recovery-prepared steady-state free precession sequence after administration of gadofosveset trisodium (contrast-enhanced CMRA). Two readers independently performed a per-segment evaluation of CMRA (8 proximal and mid coronary segments) for detection of significant stenosis (50%) using invasive coronary angiography as reference. Disagreement was settled by consensus reading and interobserver variability was assessed using an unweighted kappa statistic. Results: Whole-heart CMRA was successfully performed in 27 patients. The percentage of assessable segments was significantly lower on unenhanced CMRA compared with contrast-enhanced CMRA (Reader 1: 79% [170/216] vs. 89% [192/216], respectively; Reader 2: 73% [157/216] vs. 87% [188/216], respectively; P < 0.001). Intention-to-diagnose analysis of the consensus reading yielded sensitivity, specificity, and diagnostic accuracy of unenhanced versus contrast-enhanced CMRA as follows: 73.1% versus 73.1% (P = 1.0), 68.3% versus 80.2% (P = 0.002), and 68.9% versus 79.3% (P = 0.004), respectively. The kappa value for interobserver agreement was 0.61 (95% confidence interval = 0.50-0.72) for unenhanced CMRA and 0.72 (95% confidence interval = 0.62-0.82) for contrast-enhanced CMRA. CONCLUSIONS:: The blood-pool contrast agent gadofosveset trisodium increased the number of assessable coronary segments on whole-heart CMRA in comparison to unenhanced whole-heart CMRA. The impact of gadofosveset trisodium on diagnostic accuracy, however, was only minor.
KW - blood pool
KW - contrast agent
KW - coronary angiography
KW - gadofosveset trisodium
KW - humans
KW - magnetic resonance
UR - http://www.scopus.com/inward/record.url?scp=79751538916&partnerID=8YFLogxK
U2 - 10.1097/RLI.0b013e3181fac6ef
DO - 10.1097/RLI.0b013e3181fac6ef
M3 - Article
C2 - 21150789
AN - SCOPUS:79751538916
SN - 0020-9996
VL - 46
SP - 152
EP - 159
JO - Investigative Radiology
JF - Investigative Radiology
IS - 3
ER -