Comparison of the Diagnostic Accuracies of 1.5T and 3T Stress Myocardial Perfusion Cardiovascular Magnetic Resonance for Detecting Significant Coronary Artery Disease

Abstract

ObjectiveTo compare the diagnostic performance of cardiovascular magnetic resonance (CMR) myocardial perfusion at 1.5- and 3-tesla (T) for detecting significant coronary artery disease (CAD), with invasive coronary angiography (ICA) as the reference method.Materials and MethodsWe prospectively enrolled 281 patients (age 62.4 ± 8.3 years, 193 men) with suspected or known CAD who had undergone 1.5T or 3T CMR and ICA. Two independent radiologists interpreted perfusion defects. With ICA as the reference standard, the diagnostic performance of 1.5T and 3T CMR for identifying significant CAD (≥ 50% diameter reduction of the left main and ≥ 70% diameter reduction of other epicardial arteries) was determined.ResultsNo differences were observed in baseline characteristics or prevalence of CAD and old myocardial infarction (MI) using 1.5T (n = 135) or 3T (n = 146) systems. Sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) for detecting significant CAD were similar between the 1.5T (84%, 64%, 74%, 76%, and 0.75 per patient and 68%, 83%, 66%, 84%, and 0.76 per vessel) and 3T (80%, 71%, 71%, 80%, and 0.76 per patient and 75%, 86%, 64%, 91%, and 0.81 per vessel) systems. In patients with multi-vessel CAD without old MI, the sensitivity, specificity, and AUC with 3T were greater than those with 1.5T on a per-vessel basis (71% vs. 36%, 92% vs. 69%, and 0.82 vs. 0.53, respectively).Conclusion3T CMR has similar diagnostic performance to 1.5T CMR in detecting significant CAD, except for higher diagnostic performance in patients with multi-vessel CAD without old MI.

Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction

“…Cardiac magnetic resonance (CMR) is a well-established non-invasive modality used to image myocardial ischemia (6) as well as acute myocardial infarction (AMI) (78). Infarct size and the presence of microvascular obstruction (MVO) characterized by CMR, as well as the clinical outcomes, are associated with the level of hs-TnT (9).…”

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging—Part 3: Perfusion, Delayed Enhancement, and T1- and T2 Mapping

“…Multi-vessel disease: Balanced multi-vessel disease can result in subendocardial hypoperfusion in most, or all segments (Fig. 2, Supplementary Movie 2), which can lead to false-negative interpretation, or misdiagnosis of microvascular disease, as visual analysis reflects a relative myocardial perfusion (3). On visual analysis, a discernible signal gradient between subendocardial and subepicardial myocardium may be seen in multi-vessel disease.…”

Guideline for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging—Part 1: Standardized Protocol

“…Herein, we offer a practical standard CMR protocol for beginners designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines [1][2][3][4][5][6][7][8][9] and includes sequence terminology used by vendors, essential MR physics [10][11][12][13][14][15][16][17], imaging planes [2,18], field strength considerations [19][20][21][22][23][24][25], MRI-conditional devices [10,20,[26][27][28][29][30][31][32][33], drugs for stress tests [34], various CMR modules [16,[35][36][37][38][39][40][41][42][43][44][45]…”