CLINICAL UTILITY OF 2-DIMENSIONAL MAGNETIC-RESONANCE ANGIOGRAPHY IN DETECTING CORONARY-ARTERY DISEASE

Aims The accuracy of magnetic resonance angiography in detecting proxi mal coronary artery stenoses is unclear. We postulated that fast magne tic resonance angiography is capable of (1) imaging proximal coronary arteries, and (2) detecting stenoses of greater than or equal to 50% o f their luminal diameter. Methods and results Thirty-five patients, re ferred for analysis of angina pectoris, underwent both conventional an giography and magnetic resonance angiography of coronary arteries. A f ast k-space segmented gradient-echo technique was used during breath-h olds. Two observers, blinded to the results of conventional angiograph y, independently analysed the magnetic resonance studies for (1) lengt h of visualized segments, and (2) presence of signal voids indicative of stenoses. From 140 proximal arteries, 15 (11%) were excluded becaus e of incomplete imaging or degraded image quality. Mean length of the visualized segments was 9+/-4 mm for the left main, 62+/-16 mm for the left anterior descending, 21+/-9 mm for the left circumflex and 89+/- 32 mm for the right coronary artery. Sensitivity for detecting greater than or equal to 50% luminal diameter stenoses was 0.00 for the left circumflex, 0.53 for the left anterior descending coronary artery, 0.7 1 for the RCA and 1.00 for the left main artery. Specificity varied fr om 0.73 for the left anterior descending coronary artery to 0.96 for t he left circumflex. Inter-observer agreement was 0.90. Conclusion Thus , segmented magnetic resonance angiography is capable of non-invasive imaging of proximal coronary anatomy. Its good accuracy in detecting l eft main coronary artery disease, intermediate accuracy in detecting r ight coronary artery and left anterior descending coronary artery sten oses, and low accuracy in detecting left circumflex lesions fit within a range of sensitivities and specificities found by others. Further t echnical advances are necessary to make the technique clinically robus t.