Myocardial Perfusion Magnetic Resonance Imaging Using Sliding-Window Conjugate-Gradient Highly Constrained Back-Projection Reconstruction for Detection of Coronary Artery Disease

• Published in: The American journal of cardiology 2012-04, Vol.109 (8), p.1137-1141
• Main Authors: Ma, Heng, MD, Yang, Jun, MD, Liu, Jing, MD, Ge, Lan, PhD, An, Jing, MD, Tang, Qing, MD, Li, Han, MD, Zhang, Yu, MD, Chen, David, PhD, Wang, Yong, MD, Liu, Jiabin, MD, Liang, Zhigang, MD, Lin, Kai, MD, Jin, Lixin, MD, Bi, Xiaoming, PhD, Li, Kuncheng, MD, Li, Debiao, PhD
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Aged; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Contrast Media; Coronary Angiography; Coronary Artery Disease - diagnosis; Coronary Circulation; Coronary heart disease; Coronary Stenosis - diagnosis; Female; Heart; Humans; Image Enhancement - methods; Magnetic Resonance Angiography - methods; Male; Medical diagnosis; Medical sciences; Middle Aged; NMR; Nuclear magnetic resonance; Predictive Value of Tests; Prospective Studies; Regional Blood Flow; Sensitivity and Specificity
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.11.051

Myocardial perfusion magnetic resonance imaging (MRI) with sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution and signal/noise ratio, and reduced cardiac motion-related image artifacts. The accuracy of this technique for detecting coronary artery disease (CAD) has not been determined in a large number of patients. We prospectively evaluated the diagnostic performance of myocardial perfusion MRI with SW-CG-HYPR in patients with suspected CAD. A total of 50 consecutive patients who were scheduled for coronary angiography with suspected CAD underwent myocardial perfusion MRI with SW-CG-HYPR at 3.0 T. The perfusion defects were interpreted qualitatively by 2 blinded observers and were correlated with x-ray angiographic stenoses ≥50%. The prevalence of CAD was 56%. In the per-patient analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SW-CG-HYPR was 96% (95% confidence interval 82% to 100%), 82% (95% confidence interval 60% to 95%), 87% (95% confidence interval 70% to 96%), 95% (95% confidence interval 74% to100%), and 90% (95% confidence interval 82% to 98%), respectively. In the per-vessel analysis, the corresponding values were 98% (95% confidence interval 91% to 100%), 89% (95% confidence interval 80% to 94%), 86% (95% confidence interval 76% to 93%), 99% (95% confidence interval 93% to 100%), and 93% (95% confidence interval 89% to 97%), respectively. In conclusion, myocardial perfusion MRI using SW-CG-HYPR allows whole left ventricular coverage and high resolution and has high diagnostic accuracy in patients with suspected CAD.