Purpose-X-ray angiography is currently the standard test for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this work was the evaluation of the accuracy of a threedimensional (3D) breathhold coronary magnetic resonance angiography (MRA) technique in detecting hemodynamically significant coronary artery stenoses in a patient population with x-ray angiographic correlation.Materials and Methods-Sequential subjects (n = 33, M/F = 22/11, average age = 57) who were referred for conventional coronary angiography were enrolled in the study. The study protocol was approved by our institutional review board. Each subject gave written informed consent. Volume-targeted 3D breathhold coronary artery scans with ECG-triggered, segmented True Fast Imaging with Steady-state Precession (TrueFISP) were acquired for the left main (LM), left anterior descending (LAD), and right coronary arteries (RCAs). Coronary MRA was evaluated with conventional angiography as the gold standard.Results-The overall sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for diagnosing any hemodynamically significant coronary artery disease (≥50% diameter reduction) with coronary MRA was 87%, 57%, 72%, 68%, and 80%, respectively. The sensitivity of the technique in the LM, LAD, and RCA was 100%, 83%, and 100%, respectively. The NPV of the technique in the LM, LAD, and RCA was 100%, 82%, and 100%, respectively. Magnetic resonance imaging (MRI) has recently gained wide acceptance in cardiovascular disease examinations. Substantial progress has been made in developing MRI techniques for imaging coronary arteries in the past 10 years. These techniques can be divided into 2 major approaches based on the methods used for reducing respiration-related motion effects: freebreathing techniques with navigator echo-guided slice correction and breathhold techniques. Encouraging results have been shown using the free-breathing approach to detect significant coronary artery disease. [3][4][5] One of the shortcomings of the free-breathing approach is the relatively long imaging time per scan. Suboptimal image quality may result if heartbeat or breathing pattern changes substantially during data acquisition.
Conclusions-Three-dimensionalWith the improved gradient system in recent MRI scanners, it is now possible to obtain three-dimensional (3D) images within a single breathhold. 6 However, with the conventional gradient-echo sequence Fast Low Angle Shot (FLASH), the signal-to-noise ratio (SNR) and spatial resolution are limited because of the constraint of the imaging time. 7 Administration of MR contrast media has substantially improved the SNR and contrast-to-noise ratio (CNR) of coronary arteries. [8][9][10][11][12] However, the number of contrast-enhanced breathhold scans in an imaging session was limited by the total contrast volume allowed per subject. Potential errors in time dela...