Three-dimensional MR coronary angiography with the navigator technique for primary diagnosis of coronary artery disease: Comparison with conventional coronary angiography

Purpose: Evaluation of three-dimensional MR coronary angiography with the navigator technique for the primary diagnosis of coronary artery disease (CAD) in patients with chest pain. Materials and Methods: In this prospective study 20 patients with chest pain were examined with MR coronary angiography and conventional angiography. The three-dimensional MR coronary angiography was performed using a 1.5T scanner with an ECG-triggered 3D-FLASH-sequence and retrospective respiratory gating in the navigator technique. The MR coronary angiography was evaluated by two radiologists blinded to the results of the conventional coronary angiography. Results: One patient was excluded from further evaluation due to reduced image quality. Conventional coronary angiography excluded CAD in 8/19 patients, 11/19 patients overall showed 20 stenoses (> 50%) or occlusions. With MR coronary angiography, CAD was correctly excluded in 7 patients, one patient was false positive, one patient was false negative. 14/20 stenoses (> 50%) or occlusions were detected, 5 stenoses were diagnosed false positive. Sensitivity and specificity for primary diagnosis of CAD or detection of coronary artery stenoses were 91% and 88% or 70% and 91%, respectively. Discussion: Using MR coronary angiography with the navigator technique in the primary evaluation of CAD, the diagnosis of stenoses or occlusions of the main coronary arteries is feasible.