PURPOSE: To assess the clinical value of a magnetic resonance (MR)
coronary angiography strategy involving a small targeted volume to image
one coronary segment in a single breath hold for the detection of greater
than 50% stenosis. MATERIALS AND METHODS: Thirty-eight patients referred
for elective coronary angiography were included. The coronary arteries
were localized during single-breath-hold, three-dimensional imaging of the
entire heart. MR coronary angiography was then performed along the major
coronary branches with a double-oblique, three-dimensional, gradient-echo
sequence. Conventional coronary angiography was the reference-standard
method. RESULTS: Adequate visualization was achieved with MR coronary
angiography in 85%-91% of the proximal coronary arterial branches and in
38%-76% of the middle and distal branches. Overall, 187 (69%) of 272
segments were suitable for comparison between conventional and MR coronary
angiography. The diagnostic accuracy of MR coronary angiography for the
detection of hemodynamically significant stenoses was 92%; sensitivity,
68%; and specificity, 97%. The sensitivity in individual segments was
50%-77%, whereas the specificity was 94%-100%. CONCLUSION: Adequate
visualization of the major coronary arterial branches was possible in the
majority of patients. The observed accuracy of MR coronary angiography for
detection of hemodynamically significant coronary arterial stenosis is
promising, but it needs to be higher before this modality can be used
reliably in a clinical setting