Document Detail


Whole-heart coronary magnetic resonance angiography at 1.5 Tesla: does a blood-pool contrast agent improve diagnostic accuracy?
MedLine Citation:
PMID:  21150789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the impact of the blood-pool contrast agent gadofosveset trisodium on diagnostic accuracy of whole-heart coronary magnetic resonance angiography (CMRA) at 1.5 Tesla.
MATERIALS AND METHODS: Thirty consecutive patients with suspected coronary artery disease underwent free-breathing whole-heart CMRA at 1.5 Tesla. CMRA was performed with a T2-prepared steady-state free precession sequence (unenhanced CMRA) and an inversion-recovery-prepared steady-state free precession sequence after administration of gadofosveset trisodium (contrast-enhanced CMRA). Two readers independently performed a per-segment evaluation of CMRA (8 proximal and mid coronary segments) for detection of significant stenosis (≥50%) using invasive coronary angiography as reference. Disagreement was settled by consensus reading and interobserver variability was assessed using an unweighted kappa statistic.
RESULTS: Whole-heart CMRA was successfully performed in 27 patients. The percentage of assessable segments was significantly lower on unenhanced CMRA compared with contrast-enhanced CMRA (Reader 1: 79% [170/216] vs. 89% [192/216], respectively; Reader 2: 73% [157/216] vs. 87% [188/216], respectively; P < 0.001). Intention-to-diagnose analysis of the consensus reading yielded sensitivity, specificity, and diagnostic accuracy of unenhanced versus contrast-enhanced CMRA as follows: 73.1% versus 73.1% (P = 1.0), 68.3% versus 80.2% (P = 0.002), and 68.9% versus 79.3% (P = 0.004), respectively. The kappa value for interobserver agreement was 0.61 (95% confidence interval = 0.50-0.72) for unenhanced CMRA and 0.72 (95% confidence interval = 0.62-0.82) for contrast-enhanced CMRA.
CONCLUSIONS: The blood-pool contrast agent gadofosveset trisodium increased the number of assessable coronary segments on whole-heart CMRA in comparison to unenhanced whole-heart CMRA. The impact of gadofosveset trisodium on diagnostic accuracy, however, was only minor.
Authors:
Moritz Wagner; Roberta Rösler; Alexander Lembcke; Craig Butler; Marc Dewey; Michael Laule; Alexander Huppertz; Carsten Schwenke; Carsten Warmuth; Matthias Rief; Bernd Hamm; Matthias Taupitz
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Investigative radiology     Volume:  46     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-04     Completed Date:  2011-05-25     Revised Date:  2013-11-13    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Charité-Universitätsmedizin Berlin, Germany. moritz.wagner@charite.de
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MeSH Terms
Descriptor/Qualifier:
Contrast Media*
Coronary Artery Disease / diagnosis*,  pathology,  radionuclide imaging
Coronary Stenosis / diagnosis,  pathology,  radionuclide imaging
Female
Gadolinium / diagnostic use*
Gated Blood-Pool Imaging*
Heart*
Humans
Magnetic Resonance Imaging, Cine / instrumentation,  methods*
Male
Middle Aged
Organometallic Compounds / diagnostic use*
Predictive Value of Tests
Prospective Studies
Regression Analysis
Sensitivity and Specificity
Statistics as Topic
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 7440-54-2/Gadolinium; XM33Q67UVH/gadofosveset trisodium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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