1. Diagnostic Accuracy of Noncontrast Self-navigated Free-breathing MR Angiography versus CT Angiography: A Prospective Study in Pediatric Patients with Suspected Anomalous Coronary Arteries
- Author
-
Markus Goeller, Domenico De Santis, John W. Nance, Julian L. Wichmann, Carlo N. De Cecco, Moritz H. Albrecht, U. Joseph Schoepf, Shahryar M. Chowdhury, Christian Tesche, Thomas J. Vogl, Davide Piccini, Akos Varga-Szemes, Anthony M. Hlavacek, Arni Nutting, Marwen Eid, Virginia W. Lesslie, and Megha Penmetsa
- Subjects
medicine.medical_specialty ,Computed Tomography Angiography ,Intraclass correlation ,Diagnostic accuracy ,Coronary Angiography ,Magnetic resonance angiography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,cardiovascular diseases ,computed tomography angiography ,coronary angiography ,free-breathing self-navigated MRA ,magnetic resonance angiography ,noncontrast MRA ,pediatric cardiac imaging ,Child ,Prospective cohort study ,Computed tomography angiography ,medicine.diagnostic_test ,business.industry ,Mr angiography ,Coronary Vessels ,Coronary arteries ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Angiography ,Radiology ,business ,Free breathing ,Artery - Abstract
Rationale and Objectives To evaluate the diagnostic accuracy of a prototype noncontrast, free-breathing, self-navigated 3D (SN3D) MR angiography (MRA) technique for the assessment of coronary artery anatomy in children with known or suspected coronary anomalies, using CT angiography (CTA) as the reference standard. Materials and Methods Twenty-one children (15 male, 12.3 ± 2.6 years) were prospectively enrolled between July 2014 and August 2016 in this IRB-approved, HIPAA-compliant study. Patients underwent same-day unenhanced SN3D-MRA and contrast-enhanced CTA. Two observers rated the visualization of coronary artery segments and diagnostic confidence on a 3-point scale and assessed coronary arteries for anomalous origin, as well as interarterial and intramural course. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of SN3D-MRA for the detection of coronary artery abnormalities were calculated. Interobserver agreement was assessed using Intraclass Correlation Coefficients (ICC). Results Fourteen children showed coronary artery abnormalities on CTA. The visualization of coronary segments was rated significantly higher for CTA compared to MRA (p Conclusions Noncontrast SN3D-MRA is highly accurate for the detection of coronary artery anomalies in pediatric patients while diagnostic confidence and coronary artery visualization remain superior with CTA.
- Published
- 2019
- Full Text
- View/download PDF