ISSN 1004-4140
CN 11-3017/P
WANG H Y, CHEN Y, HUANG P, et al. Non-contrast-enhanced 3.0T Whole-heart Coronary MRA: Comparison of Diagnostic Performance between mDixon and WHCA TFE Sequence Using SPIR in CAD Using Coronary Angiography as Reference[J]. CT Theory and Applications, 2025, 34(1): 9-16. DOI: 10.15953/j.ctta.2024.185. (in Chinese).
Citation: WANG H Y, CHEN Y, HUANG P, et al. Non-contrast-enhanced 3.0T Whole-heart Coronary MRA: Comparison of Diagnostic Performance between mDixon and WHCA TFE Sequence Using SPIR in CAD Using Coronary Angiography as Reference[J]. CT Theory and Applications, 2025, 34(1): 9-16. DOI: 10.15953/j.ctta.2024.185. (in Chinese).

Non-contrast-enhanced 3.0T Whole-heart Coronary MRA: Comparison of Diagnostic Performance between mDixon and WHCA TFE Sequence Using SPIR in CAD Using Coronary Angiography as Reference

More Information
  • Received Date: August 25, 2024
  • Revised Date: October 05, 2024
  • Accepted Date: October 08, 2024
  • Available Online: November 07, 2024
  • Objective: To compare the diagnostic performance between mDixon sequence and WHCA TFE sequence using SPIR for non-contrast-enhanced coronary MRA in patients with suspected coronary artery disease (CAD). Method: This prospective study recruited 45 patients who were scheduled for X-ray coronary angiography (CAG) with suspected CAD in Yantai Yuhuangding hospital. Patients underwent both 3.0T WHCA TFE using SPIR and mDixon coronary MRA examinations before undergoing CAG. Two radiologists independently assessed coronary arteries in terms of subjective image quality (on a scale of 1~5, with 5 denoting the highest image quality), vessel length, vessel diameter, and presence of significant stenoses. CAG was used as the reference standard for detecting the presence of stenoses. Vessel length and diameter were compared between sequences using paired t-tests. Subjective image quality scores were compared between sequences using Wilcoxon tests. Sensitivity, specificity, and accuracy were compared between sequences using McNemar tests. Positive and negative predictive values were compared between sequences using the joint hypotheses test. Results: Two CMRA examinations were successfully performed in 40 (88.9%) of 45 patients for analysis. The objective image quality of 3.0T mDixon assessed by both radiologists was (3.9±0.9), and the 3.0T WHCA TFE using SPIR was (3.7±0.9). The mDixon sequence exhibited higher sensitivity, specificity, accuracy, positive predictive value, and negative predictive value in per-segment analysis (78.5% vs. 66.1%, 96.5% vs. 93.8%, 91.7% vs. 86.6%, 88.6% vs. 78.9%, and 93.4% vs. 88.7%) and higher sensitivity and accuracy in per-vessel analysis (89.4% vs. 81.6% and 89.1% vs. 83.3%). Conclusion: In comparison with 3.0T WHCA TFE sequence using SPIR, mDixon demonstrated superior diagnostic performance.

  • [1]
    MANNING W J, LI W, EDELMAN R R. A preliminary report comparing magnetic resonance coronary angiography with conventional angiography[J]. The New England Journal of Medicine, 1993, 328(12): 828-832. DOI: 10.1056/NEJM199303253281202.
    [2]
    MOLEN A J, REIMER P, DEKKERS I A, et al. Post-contrast acute kidney injury-Part 2: Risk stratification, role of hydration and other prophylactic measures, patients taking metforminand chronic dialysis patients: Recommendations for updated ESUR Contrast Medium Safety Committee guidelines[J]. European Radiology, 2018, 28(7): 2856-2869. DOI: 10.1007/s00330-017-5247-4.
    [3]
    MOLEN A J, REIMER P, DEKKERS I A, et al. Post-contrast acute kidney injury-Part 1: Definition, clinical features, incidence, role of contrast medium and risk factors: Recommendations for updated ESUR Contrast Medium Safety Committee guidelines[J]. European Radiology, 2018, 28(7): 2845-2855. DOI: 10.1007/s00330-017-5246-5.
    [4]
    HE A, KWATRA S G, ZAMPELLA J G, et al. Nephrogenic systemic fibrosis: Fibrotic plaques and contracture following exposure to gadolinium-based contrast media[D]. BMJ Case Reports, 2016.
    [5]
    BI X, DESHPANDE V, SIMONETTI O, et al. Three-dimensional breathhold SSFP coronary MRA: A comparison between 1.5T and 3.0T[J]. Journal of Magnetic Resonance Imaging, 2005, 22(2): 206-212. DOI: 10.1002/jmri.20374.
    [6]
    SIMON J H, SZUMOWSKI J. Proton (fat/water) chemical shift imaging in medical magnetic resonance imaging: Current status[J]. Investigative Radiology, 1992, 27(10): 865-874. DOI: 10.1097/00004424-199210000-00018.
    [7]
    KAUL M G, STORK A, BANSMANN P M, et al. Evaluation of balanced steady-state free precession (TrueFISP) and K-space segmented gradient echo sequences for 3D coronary MR angiography with navigator gating at 3 Tesla[J]. Rofo, 2004, 176(11): 1560-1565. DOI: 10.1055/s-2004-813629.
    [8]
    KAWADA H, GOSHIMA S, SAKURAI K, et al. Utility of noncontrast magnetic resonance angiography for aneurysm follow-up and detection of endoleaks after endovascular aortic repair[J]. Korean Journal of Radiology, 2021, 22(4): 513-524. DOI: 10.3348/kjr.2020.0001.
    [9]
    CHEN Y, GUO H, DONG P, et al. Feasibility of 3.0T balanced fast field echo non-contrast-enhanced whole-heart coronary magnetic resonance angiography[J]. Cardiovascular Diagnosis and Therapy, 2023, 13(1): 51-60. DOI: 10.21037/cdt-22-487.
    [10]
    EGGERS H, BRENDEL B, DUIJNDAM A, et al. Dual-echo Dixon imaging with flexible choice of echo times[J]. Magnetic Resonance in Medicine, 2011, 65(1): 96-107. DOI: 10.1002/mrm.22578.
    [11]
    KOURTIDOU S, JONES M R, MOORE R A, et al. mDixon ECG-gated 3-dimensional cardiovascular magnetic resonance angiography in patients with congenital cardiovascular disease[J]. Journal of Cardiovascular Magnetic Resonance, 2019, 21(1): 52. DOI: 10.1186/s12968-019-0554-3.
    [12]
    WEISS K J, EGGERS H, STEHNING C, et al. Feasibility and robustness of 3T magnetic resonance angiography using modified dixon fat suppression in patients with known or suspected peripheral artery disease[J]. Frontiers in Cardiovascular Medicine, 2020, 7: 549392. DOI: 10.3389/fcvm.2020.549392.
    [13]
    TIAN D, ZHAO S H, WANG Y, et al. Unenhanced whole-heart coronary MRA: Prospective intraindividual comparison of 1.5-T SSFP and 3-T Dixon water-fat separation gre methods using coronary angiography as reference[J]. American Journal of Roentgenology, 2022, 219(2): 199-211. DOI: 10.2214/AJR.21.27292.
    [14]
    BECKER H, WATTENBERG M, BARTH P, et al. Impact of different respiratory monitoring techniques on respiration-dependent stroke-volume measurements assessed by real-time magnetic resonance imaging[J]. Zeitschrift Für Medizinische Physik, 2019, 29(4): 349-358.
    [15]
    AUSTEN W G, EDWARDS J E, FRYE R L, et al. A reporting system on patients evaluated for coronary artery disease. Report of the AD HOC committee for grading of coronary artery disease, council on cardiovascular surgery[J]. American Heart Association. Circulation, 1975, 51(S4): 5-40.
    [16]
    DUERINCKX A J, URMAN M K. Two-dimensional coronary MR angiography: Analysis of initial clinical results[J]. Radiology, 1994, 193(3): 731-738. DOI: 10.1148/radiology.193.3.7972815.
    [17]
    YANG Q, LI K, LIU X, et al. Contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0-T: A comparative study with X-ray angiography in a single center[J]. Journal of the American College of Cardiology, 2009, 54(1): 69-76. DOI: 10.1016/j.jacc.2009.03.016.
    [18]
    周妙平, 张兆琪, 于薇, 等. 3.0T非增强全心冠状动脉MR成像评价冠状动脉狭窄的初步研究[J]. 中华放射学杂志, 2013, 47(10): 883-888. DOI: 10.3760/cma.j.issn.1005-1201.2013.10.004.

    ZHOU M P, ZHANG Z Q, YU W, et al. Preliminary study on non-contrast-enhanced whole-heart coronary magnetic resonance angiography at 3.0T to evaluate the coronary stenosis[J]. Chinese Journal of Radiology, 2013, 47(10): 883-888. DOI: 10.3760/cma.j.issn.1005-1201.2013.10.004. (in Chinese).
    [19]
    LU H, ZHAO S, TIAN D, et al. Clinical application of non-contrast-enhanced dixon water-fat separation compressed sense whole-heart coronary MR angiography at 3.0T with and without nitroglycerin[J]. Journal of Magnetic Resonance Imaging, 2022, 55(2): 579-591. DOI: 10.1002/jmri.27829.
    [20]
    SCHACHINGER V, BRITTEN M B, ZEIHER A M. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease[J]. Circulation, 2000, 101(16): 1899-1906.
    [21]
    DIXON W T. Simple proton spectroscopic imaging[J]. Radiology, 1984, 153(1): 189-194.
    [22]
    NEZAFAT M, HENNINGSSON M, RIPLEY D P, et al. Coronary MR angiography at 3T: Fat suppression versus water-fat separation[J]. Magma, 2016, 29(5): 733-738. DOI: 10.1007/s10334-016-0550-7.
    [23]
    BORNERT P, KOKEN P, NEHRKE K, et al. Water/fat-resolved whole-heart Dixon coronary MRA: An initial comparison[J]. Magnetic Resonance in Medicine, 2014, 71(1): 156-163. DOI: 10.1002/mrm.24648.
    [24]
    KOKTZOGLOU I, EDELMAN R R. Radial fast interrupted steady-state (FISS) magnetic resonance imaging[J]. Magnetic Resonance in Medicine, 2018, 79(4): 2077-2086. DOI: 10.1002/mrm.26881.
    [25]
    BASTIAANSEN J, PICCINI D, DI S L, et al. Natively fat-suppressed 5D whole-heart MRI with a radial free-running fast-interrupted steady-state (FISS) sequence at 1.5T and 3T[J]. Magnetic Resonance in Medicine, 2020, 83(1): 45-55. DOI: 10.1002/mrm.27942.
    [26]
    BASTIAANSEN J, STUBER M. Flexible water excitation for fat-free MRI at 3T using lipid insensitive binomial off-resonant RF excitation (LIBRE) pulses[J]. Magnetic Resonance in Medicine, 2018, 79(6): 3007-3017. DOI: 10.1002/mrm.26965.
    [27]
    BASTIAANSEN J, Van HEESWIJK R B, STUBER M, et al. Noncontrast free-breathing respiratory self-navigated coronary artery cardiovascular magnetic resonance angiography at 3T using lipid insensitive binomial off-resonant excitation (LIBRE)[J]. Journal of Cardiovascular Magnetic Resonance, 2019, 21(1): 38. DOI: 10.1186/s12968-019-0543-6.
    [28]
    于兵, 孙红彬, 侯阳, 等. 心率变异率对3.0T磁共振自由呼吸全心冠状动脉成像图像质量的影响[J]. 中国医学影像技术, 2010, 26(2): 282-284.

    YU B, SUN H B, HOU Y, et al. Effect of heart rate variability on image quality of 3D free-breathing whole-heart coronary MR angiography with 3.0T scanner[J]. Chinese Journal of Medical Imaging Technology, 2010, 26(2): 282-284. (in Chinese).
    [29]
    戴沁怡, 贺毅, 张兆琪, 等. 全心冠状动脉MR成像的图像质量及其影响因素[J]. 中国医学影像技术, 2013, 29(2): 293-297.

    DAI X Y, HE Y, ZHANG Z Q, et al. Image quality and impact factors of whole-heart coronary MR angiography[J]. Chinese Journal of Medical Imaging Technology, 2013, 29(2): 293-297. (in Chinese).
    [30]
    鲁鸿飞, 田地, 赵士海, 等. 3.0T非增强Dixon水脂分离压缩感知冠状动脉MR血管成像诊断冠状动脉狭窄的效能研究[J]. 中华放射学杂志, 2022, 56(10): 1051-1057. DOI: 10.3760/cma.j.cn112149-20211227-01152.

    LU H F, TIAN D, ZHAO S H, et al. A study on diagnostic performance of 3.0T non-contrast-enhanced dixon water-fat separation compressed SENSE whole-heart coronary MR angiography[J]. Chinese Journal of Radiology, 2022, 56(10): 1051-1057. DOI: 10.3760/cma.j.cn112149-20211227-01152. (in Chinese).
  • Related Articles

    [1]ZHOU Yan, HE Yi, LI Fang, XU Yinghao, MA Tian, ZHONG Chaohui. A Subtraction Coronary Computed Tomography Angiography Technique to Evaluate In-stent Restenosis[J]. CT Theory and Applications, 2025, 34(4): 660-666. DOI: 10.15953/j.ctta.2024.240
    [2]LEI Lixing, HUANG Xiaohua, LIU Nian, TANG Lingling, MA Linjun. Analysis of Accuracy, Image Quality, and Effective Dose of Coronary CT Angiography Using Dual-Source CT with Turbo-Flash Mode to Evaluate Coronary Artery Stenosis[J]. CT Theory and Applications. DOI: 10.15953/j.ctta.2024.350
    [3]ZANG Yanwei, ZHANG Jing. Diagnostic Value of CT Coronary Angiography Combined with MMP-10 and F-ABP in Myocardial Infarction[J]. CT Theory and Applications, 2020, 29(4): 481-487. DOI: 10.15953/j.1004-4140.2020.29.04.11
    [4]CHEN An, JIE Xue-qian, WANG Zheng, LI Yuan, ZHANG Hao, LI Nian-yun, MENG Jie. Value of Ultra-low Dose Coronary CT Angiography for Classification and Quantification of Coronary Stenosis[J]. CT Theory and Applications, 2018, 27(6): 701-707. DOI: 10.15953/j.1004-4140.2018.27.06.03
    [5]DONG Jian, YANG Lei, YAN Nuan, WEN Jing, ZHANG Chun-yan, CHEN Xiao-bo, WEN Ting-guo, WANG Ren-gui. Coronary Artery CT Angiography in Coronary-pulmonary Fistula:A Retrospective Study[J]. CT Theory and Applications, 2017, 26(4): 519-524. DOI: 10.15953/j.1004-4140.2017.26.04.15
    [6]BAI Shao-jun, LI Li. The Diagnostic Value of Conventional CTA and Subtraction CTA on Carotid Artery Stenosis[J]. CT Theory and Applications, 2015, 24(3): 415-420. DOI: 10.15953/j.1004-4140.2015.24.03.11
    [7]LI Wei. Clinical Value of CTA Applied in Coronary Artery Stenosis[J]. CT Theory and Applications, 2014, 23(5): 857-862.
    [8]ZHANG Chao-zong. System Structure and Performance Parameters of Industrial CT[J]. CT Theory and Applications, 2014, 23(3): 443-452.
    [9]CHEN Hong-cai, LU Jin-guo, PENG Wan-hong, XI Ren-gang. Diagnosis of Coronary Luminal Stenosis in Dual-source CT Coronary Angiography Using Low-tube-voltage[J]. CT Theory and Applications, 2014, 23(3): 371-377.
    [10]LI Shu-jian, FANG Jia. The Diagnostic Value of 64-slice Multislice Computed Tomography Angiography for Symptomatic Carotid Artery Stenosis[J]. CT Theory and Applications, 2011, 20(3): 371-376.

Catalog

    Article views (140) PDF downloads (17) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return