Contrast-enhanced MR imaging for evaluation of coronary artery disease before elective repair of aortic aneurysm.

Abstract

PURPOSE:

To prospectively evaluate the accuracy of first-pass contrast material-enhanced magnetic resonance (MR) imaging during stress and delayed contrast-enhanced MR imaging in the detection of significant coronary artery disease in patients before elective repair of aortic aneurysm.

MATERIALS AND METHODS:

The study was approved by the institutional ethics committee, and informed consent was obtained from all patients. MR imaging was performed in 49 patients (42 men and seven women; mean age, 72.2 years; age range, 58-85 years) before the elective repair of atherosclerotic aortic aneurysms. Thirty-two patients had an abdominal aneurysm, 12 had a thoracic aneurysm, and five had a thoracoabdominal aneurysm. First-pass contrast-enhanced MR images were obtained with short-axis sections encompassing the entire left ventricular myocardium in the resting state and during pharmacologic stress. Inversion-recovery-prepared delayed contrast-enhanced MR images were obtained with breath holding to evaluate for the presence of infarction. All patients underwent coronary angiography within 2 weeks of MR imaging, and these findings were used as the standard of reference. The diagnostic results of first-pass contrast-enhanced MR imaging, delayed contrast-enhanced MR imaging, and a combination of both MR imaging methods in the detection of significant coronary artery disease were expressed as sensitivity, specificity, and accuracy.

RESULTS:

Coronary angiography depicted a clinically significant stenosis (>70% luminal diameter narrowing) in the coronary artery in 34 of the 49 patients (69%). First-pass contrast-enhanced MR imaging depicted stress-induced hypoenhancement in 27 of those 34 patients (79%). Delayed myocardial enhancement was observed in 17 of the 34 patients (50%). The overall sensitivity of rest-stress first-pass contrast-enhanced MR imaging and delayed contrast-enhanced MR imaging combined in the prediction of at least one coronary artery with significant stenosis was 88% (30 of 34 patients). The specificity and accuracy of MR imaging were 87% (13 of 15 patients) and 88% (43 of 49 patients), respectively.

CONCLUSION:

Contrast-enhanced MR imaging had an accuracy of 88% in the detection of significant coronary artery disease in patients with aortic aneurysm.

• Authors: Masaki Ishida, Hajime Sakuma, Noriyuki Kato, Nanaka Ishida, Kakuya Kitagawa, Takatsugu Shimono, Isao Yada, Kan Takeda
• Journal: Radiology (Radiology) Vol. 237 Issue 2 Pg. 458-64 (Nov 2005) ISSN: 0033-8419 [Print] United States
• PMID: 16170013 (Publication Type: Journal Article)

Chemical References

• Contrast Media

Topics

• Aged
• Aged, 80 and over
• Aortic Aneurysm (complications, surgery)
• Contrast Media
• Coronary Angiography
• Coronary Artery Disease (complications, diagnosis)
• Female
• Humans
• Magnetic Resonance Angiography (methods)
• Male
• Middle Aged
• Prospective Studies
• Sensitivity and Specificity