Comparison of three-dimensional contrast-enhanced magnetic resonance angiography and axial radiographic angiography for diagnosing congenital stenoses in small pulmonary arteries

Accuracy of 3-dimensional contrast-enhanced magnetic resonance angiography (MRA) in diagnosing morphology of the branch pulmonary artery (PA) was eval uated in 73 patients (aged 7.2 +/- 6.4 years [mean +/- SD]) with various co ngenital heart diseases. The presence or absence of localized stenosis of b ranch PAs, PA diameter, and Nakata's PA index were determined on MRA and ax ial radiographic angiography, and the results were compared. Sensitivity, s pecificity, and overall accuracy in detecting branch PA stenoses were 92.7% , 96.2%, and 95.2%, respectively. Correlations between axial radiographic a ngiography and MRA were excellent in measuring PA diameter (r = 0.956, SEE = 1.49 mm, n = 139) as well as PA index (r = 0.839, SEE = 48.9, n = 37); bo th p < 0.0001. Bland-Altman plots showed a mean difference +/- SD for PA di ameter of 0.17 +/- 1.51 mm and for PA index of 8.5 +/- 50.1. When the main right and left PAs were token as the first generation, the most distal bran ches visible on MRA were the 4.7 +/- 0.7 generation with breath-holding (n = 23) and the 3.7 +/- 0.5 without breath-holding (n = 50), respectively (p < 0.0001). Both intra- and interobserver variabilities of MRA measurements were few (9.5 +/- 11.6% and 13.5 +/- 15.0%, respectively, n = 139). In conc lusion, 3-dimensional contrast-enhanced MRA enables vs to document branch P A morphology clearly in infants and adult patients with congenital cardiova scular defects. (C) 2001 by Excerpta Medica, Inc.