ISSN 1004-4140
CN 11-3017/P
| 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).
|
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).
|
| [1] | YAN Xin, ZHAO Jianhua. Research Progress of Pericoronary Adipose Tissue Radiomics Based on Coronary Computed Tomography Angiography[J]. CT Theory and Applications, 2024, 33(4): 531-538. DOI: 10.15953/j.ctta.2023.179 |
| [2] | HE Weihong, FANG Tingsong, FU Xi, LAO Meiling, XIAO Xiuyun. Risk Factors of Vulnerable Coronary Plaque Formation in Type 2 Diabetes[J]. CT Theory and Applications, 2023, 32(4): 523-529. DOI: 10.15953/j.ctta.2023.036 |
| [3] | ZHU Najun, FANG Xinxin, YIN Yijun, ZHOU Shuitian. Risk Factors of Plaque Progression in Patients with Angina Pectoris and Their Relationships with Coronary CT Angiography[J]. CT Theory and Applications, 2023, 32(2): 217-222. DOI: 10.15953/j.ctta.2022.219 |
| [4] | LIANG Yu, ZHANG Xiao-qin. Current State and Progress of Coronary Angiography in Multi-slice Spiral Computed Tomography Imaging Techniques[J]. CT Theory and Applications, 2016, 25(6): 725-735. DOI: 10.15953/j.1004-4140.2016.25.06.14 |
| [5] | HAN Hong-cheng. The Application of Multi Slice Spiral CT Angiography in Coronary Heart Disease[J]. CT Theory and Applications, 2015, 24(6): 843-848. DOI: 10.15953/j.1004-4140.2015.24.06.10 |
| [6] | YANG Chun-yu, SHEN Bi-xian, ZHAO Yue, HUANG Yin-ping, CHEN Sheng-ji, HUANG An-rong. Study on the Value of Dual Source CT Assessment of Correlation between Diabetes and Coronary Plaque[J]. CT Theory and Applications, 2014, 23(6): 913-921. |
| [7] | ZHAO Yue, SHEN Bi-xian, TAN Si-ping, YANG Chun-yu, CHEN Sheng-ji, HUANG An-rong. Study on the Value of Dual Source CT Assessment of Smoking and Coronary Plaque Correlation[J]. CT Theory and Applications, 2014, 23(4): 541-550. |
| [8] | TIAN Shu-ping, YANG Li, WANG Zhan-yu, WANG Shou-hai, WANG Zi-jun, ZHANG Yan-qun. The Application of “Magic Glass” Function in Coronary CTA[J]. CT Theory and Applications, 2012, 21(4): 721-726. |
| [9] | LIU Chao, ZHOU Xuan-ming, GONG Xiao-hong, CHEN Lun-gang. Clinical Significance of Evaluating Coronary Atherosclerotic Plaque with 64-Slice CT[J]. CT Theory and Applications, 2010, 19(2): 105-111. |
| [10] | XU Hui-min, HUO Jian-wei, LI Bao-ping, ZENG Qing-yu. Evaluation of Coronary Heart Disease using MDCT Coronary Angiography Combined with Ultrasound[J]. CT Theory and Applications, 2004, 13(4): 55-59. |
Supported by: Beijing Renhe Information Technology Co. Ltd 
DownLoad: