Whole Left Ventricular Coverage Versus Conventional 3-Slice Myocardial Perfusion Magnetic Resonance Imaging for the Detection of Suspected Coronary Artery Disease

Heng Ma; Yue Zhang; Jingjing Chen; Jun Yang

doi:10.1016/j.acra.2018.05.008

Whole Left Ventricular Coverage Versus Conventional 3-Slice Myocardial Perfusion Magnetic Resonance Imaging for the Detection of Suspected Coronary Artery Disease

Acad Radiol. 2019 Apr;26(4):519-525. doi: 10.1016/j.acra.2018.05.008. Epub 2018 Jun 7.

Authors

Heng Ma¹, Yue Zhang², Jingjing Chen³, Jun Yang⁴

Affiliations

¹ Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China.
² Department of Radiology, University of Chicago, Chicago, Illinois.
³ Department of Radiology, The Affiliated Hospital of Qingdao University, Shandong, China. Electronic address: xhzyhd@163.com.
⁴ Yuhuangding Hospital, Qingdao University School of Medicine, Yantai, China. Electronic address: yangjunyhd@163.com.

PMID: 29887399
DOI: 10.1016/j.acra.2018.05.008

Abstract

Rationale and objectives: Sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution, and signal-to-noise ratio compared to the conventional 3-slice saturation recovery turbo-fast low-angle shot (SR-Turbo-FLASH) sequence. We prospectively compared the diagnostic value of whole leftventricular coverage myocardial perfusion magnetic resonance imaging (MRI) and conventional 3-slice technique in patients with suspected coronary artery disease (CAD).

Materials and methods: Thirty consecutive patients with suspected CAD who were scheduled for coronary angiography underwent myocardial perfusion MRI with both SW-CG-HYPR and SR-Turbo-FLASH in random order at 3.0 T. Perfusion defects were interpreted visually by two blinded observers and were correlated to x-ray angiographic stenoses ≥50%. Receiver-operating characteristic curve analysis was used to compare the diagnostic performance of the two imaging techniques.

Results: The image quality score of SW-CG-HYPR was significantly higher than that of SR-Turbo-FLASH (3.4 ± 0.6 vs 3.0 ± 0.7, respectively; p < 0.05). In the per-patient analysis, SW-CG-HYPR provided a higher sensitivity (94% vs 89%), specificity (83% vs 75%), and diagnostic accuracy (90% vs 83%) for the detection of CAD than SR-Turbo-FLASH. In the per-vessel analysis, the diagnostic performance of SW-CG-HYPR was significantly greater than that of SR-Turbo-FLASH for the overall detection of CAD (area under receiver-operating characteristic curve: 0.96 ± 0.02 vs 0.90 ± 0.03, respectively; p < 0.05).

Conclusion: Whole left ventricular coverage myocardial perfusion MRI has higher diagnostic accuracy compared to conventional 3-slice technique for the detection of suspected CAD.

Keywords: Coronary artery disease; Magnetic resonance imaging; Myocardial perfusion; SW-CG-HYPR; Whole left ventricular coverage.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Coronary Angiography / methods
Coronary Artery Disease / diagnosis*
Female
Heart Ventricles / diagnostic imaging*
Humans
Magnetic Resonance Angiography / methods
Male
Middle Aged
Myocardial Perfusion Imaging / methods*
Reproducibility of Results
Sensitivity and Specificity