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Previous Volume 328:828-832 March 25, 1993 Number 12 Next

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ABSTRACT

Background The ability to assess the patency of coronary arteries by noninvasive means would represent an important advance. We have developed a magnetic resonance imaging (MRI) coronary angiographic technique that permits the display of areas of abnormal coronary blood flow. We have compared this method with conventional contrast angiography for the identification of coronary-artery stenoses.

Methods MRI coronary angiography was performed with an electrocardiographically gated sequence in 39 subjects, 33 to 84 years of age, who were scheduled for elective cardiac catheterization with coronary angiography. Sequential overlapping transverse and oblique sections were acquired during periods of breath-holding and were displayed as cine loops for analysis. MRI and conventional angiographic data were compared in a blinded manner. The four major epicardial coronary arteries were classified by MRI coronary angiography as being normal (or having only minimal irregularities) or as having disease that was moderately severe to severe.

Results The sensitivity and specificity of MRI coronary angiography, as compared with conventional angiography, for correctly identifying individual vessels with 50 percent angiographic stenoses were 90 percent and 92 percent, respectively. The corresponding positive and negative predictive values were 0.85 and 0.95, respectively. The sensitivity and specificity of the technique were 100 percent and 100 percent, respectively, for the left main coronary artery, 87 percent and 92 percent for the left anterior descending coronary artery, 71 percent and 90 percent for the left circumflex coronary artery, and 100 percent and 78 percent for the right coronary artery.

Conclusions MRI coronary angiography provides a new approach to evaluating the patency of coronary arteries. These preliminary data suggest that this technique may provide a noninvasive means of evaluating patients with known or suspected coronary artery disease. At its current stage of development, this procedure may be most helpful for excluding clinically important stenoses in patients referred for diagnostic contrast angiography. .

Source Information

From the Cardiovascular Division of the Department of Medicine (W.J.M.) and the Department of Radiology (W.J.M., W.L., R.R.E.), Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory, Beth Israel Hospital, and Harvard Medical School, Boston.

Address reprint requests to Dr. Manning at the Cardiovascular Division, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.

Full Text of this Article

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MRI Coronary Angiography
Bittl J. A., Paulin S., Manning W. J., Edelman R. R., Steinberg E. P.
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N Engl J Med 1993; 329:507-508, Aug 12, 1993. Correspondence

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