Comparison of three-dimensional volume-targeted thin-slab FIESTA magnetic resonance angiography and 64-multidetector computed tomographic angiography for the identification of proximal coronary stenosis

Diagnostic accuracy of whole heart coronary magnetic resonance angiography: a systematic review and meta-analysis

BACKGROUND

The purpose of this meta-analysis was to comprehensively investigate the diagnostic ability of 1.5 T and 3.0 T whole heart coronary angiography (WHCA) to detect significant coronary artery disease (CAD) on X-ray coronary angiography.

METHODS

A literature search of electronic databases, including PubMed, Web of Science Core Collection, Cochrane advanced search, and EMBASE, was performed to retrieve and integrate articles showing significant CAD detectability of 1.5 and 3.0 T WHCA.

RESULTS

Data from 1899 patients from 34 studies were included in the meta-analysis. 1.5 T WHCA had a summary area under ROC of 0.88 in the patient-based analysis, 0.90 in the vessel-based analysis, and 0.92 in the segment-based analysis. These values for 3.0 T WHCA were 0.94, 0.95, 0.96, respectively. Contrast-enhanced 3.0 T WHCA had significantly higher specificity than non-contrast-enhanced 1.5 T WHCA on a patient-based analysis (0.87, 95% CI 0.80-0.92 vs. 0.74, 95% CI 0.64-0.82, P = 0.02). There were no differences in diagnostic performance on a patient-based analysis by use of vasodilators, beta-blockers or between Asian and Western countries.

CONCLUSIONS

The diagnostic performance of WHCA was deemed satisfactory, with contrast-enhanced 3.0 T WHCA exhibiting higher specificity compared to non-contrast-enhanced 1.5 T WHCA in a patient-based analysis. There were no significant differences in diagnostic performance on a patient-based analysis in terms of vasodilator or beta-blocker use, nor between Asian and Western countries. However, further large-scale multicentre studies are crucial for the widespread global adoption of WHCA.

High spatial resolution coronary magnetic resonance angiography at 7 T: comparison with low spatial resolution bright blood imaging

OBJECTIVES

The aim of this study was to compare bright blood high spatial resolution (HR) coronary magnetic resonance angiography (MRA) with low spatial resolution (LR) bright blood coronary MRA at 7 T.

MATERIALS AND METHODS

Twenty-four healthy volunteers underwent navigator-gated 3-dimensional imaging of the right coronary artery at 7 T using 2 sequences: HR bright blood and LR bright blood. Image postprocessing involved newly developed multiplanar reformatting to straighten the right coronary artery. Image quality was determined by vessel edge sharpness, signal-to-noise ratio, contrast-to-noise ratio, visible vessel length, and vessel diameter.

RESULTS

Vessel edge sharpness was statistically significantly higher in HR as compared with LR (0.57 ± 0.1 vs 0.46 ± 0.06; P < 0.001), at the cost of lower signal-to-noise ratio (HR, 32.9 ± 11.0 vs LR, 112.5 ± 48.9; P < 0.001) and contrast-to-noise ratio (HR, 17.9 ± 7.4 vs LR, 50.5 ± 26.1; P < 0.001). Visible vessel length and vessel diameter were similar for both sequences (P > 0.05).

CONCLUSIONS

High spatial resolution bright blood coronary MRA at 7 T is feasible and improves vessel edge sharpness as compared with LR bright blood imaging.

Imaging characteristics of cardiac dominant diffuse large B-cell lymphoma demonstrated with MDCT and PET/CT

PURPOSE

To investigate the specific imaging findings of multidetector row CT (MDCT) and PET/CT with(18)F-FDG in cardiac dominant diffuse large B-cell lymphoma (DLBCL) in comparison with other cardiac tumours.

METHODS

Five patients with DLBCL and 12 patients with other cardiac tumours including pericardial tumours were retrospectively reviewed. Among the patients with other cardiac tumours, seven had metastatic tumours, three had benign tumours, and two had other malignant cardiac tumours. The location of the cardiac mass, the encasement of the coronary artery surrounded by the mass, and pericardial effusion were evaluated using MDCT. The disease activity of the cardiac tumour was also evaluated by PET/CT.

RESULTS

Four of the five DLBCL patients had primarily right-sided cardiac lesions, which was seen significantly more frequently in DLBCL than in other cardiac tumours (p = 0.028). All cardiac DLBCL lesions were located around the atrioventricular groove and encased the coronary arteries. ECG-gated cardiac MDCT showed that there was no apparent stenosis of the coronary arteries. Large amounts of pericardial effusion were seen in all DLBCL patients. PET/CT revealed significantly higher FDG uptake in DLBCL than in other cardiac malignant tumours, with no overlap (p = 0.0007).

CONCLUSION

The combination of a right-sided cardiac mass with a large pericardial effusion and no apparent stenosis of the encased coronary artery revealed by MDCT and a high maximum standard uptake value were the specific findings in cardiac dominant DLBCL.