Clinical Application of Non‐Contrast‐Enhanced Dixon Water‐Fat Separation Compressed SENSE Whole‐Heart Coronary MR Angiography at 3.0 T With and Without Nitroglycerin. Issue 2 (13th July 2021)

• Record Type: Journal Article
• Authors: Lu, Hongfei; Zhao, Shihai; Tian, Di; Yang, Shan; Ma, Jianying; Chen, Yinyin; Ge, Meiying; Zeng, Mengsu; Jin, Hang
• Is Part Of: Journal of magnetic resonance imaging. Volume 55:Issue 2(2022)
• Page Start: 579
• Page End: 591
• Publication Date: 2021-07-13
• Subjects: coronary artery disease -- MR angiography -- Dixon water‐fat separation -- compressed SENSE -- diagnostic performance -- vasodilation; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.27829
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: 3.0 T non‐contrast‐enhanced nitroglycerin (NTG)‐assisted whole‐heart coronary magnetic resonance angiography (MRA) employing Dixon water‐fat separation and compressed SENSE (CS‐SENSE) acceleration is a promising method for diagnosing coronary artery disease (CAD). Purpose: To evaluate the diagnostic performance of this technique for detecting clinically‐relevant (≥50% diameter reducing) CAD and to evaluate the difference in NTG‐induced coronary vasodilation between patients with and without clinically‐relevant CAD. Study Type: Prospective. Population: Sixty‐six patients with suspected CAD. Field Strength/Sequence: 3.0 T; CSSENSE, Dixon water‐fat separation, three‐dimensional segmented turbo field gradient‐echo sequence for whole‐heart coronary MRA. Assessment: Overall image quality of coronary MRA was calculated on the basis of all visible coronary segments. The diagnostic performance of coronary MRA for detecting a ≥50% reduction in coronary artery diameter with and without NTG was compared using X‐ray coronary angiography (CAG) as the reference. According to CAG, patients were divided into a non‐clinically‐relevant CAD group and clinically‐relevant CAD group, and the difference in NTG‐induced vasodilation between the groups was evaluated. Statistical Tests: Unpaired/paired Student's t ‐test, Mann–Whitney U test, paired Wilcoxon signed‐rank test, χ 2 test, McNemar test. A two‐tailed P value <0.05 was considered significant. Results: Overall image quality was increased significantly in the coronary MRA images after NTG. The diagnostic performance of the non‐NTG vs. NTG‐assisted coronary MRA was as follows on a per‐patient basis: sensitivity 94.3% vs. 94.3%, specificity 64.5% vs. 83.9%, positive predictive value 75.0% vs. 86.8%, negative predictive value 90.9% vs. 92.9%, and accuracy 80.3% vs. 89.4%, respectively. NTG‐induced vasodilation was significantly lower in the clinically‐relevant CAD group than in the non‐clinically‐relevant CAD group (13.7 ± 8.1% vs. 24.1 ± 16.3%). Data Conclusion: Non‐contrast Dixon water‐fat separation CS‐SENSE coronary MRA at 3.0 T can noninvasively detect clinically‐relevant CAD and sublingual NTG improved performance. Combining pre‐ and post‐NTG coronary MRA may provide a simple noninvasive and nonionizing test to evaluate coronary vasodilation function. Level of Evidence: 1 Technical Efficacy Stage: 2