Coronary magnetic resonance angiography for the detection of coronary stenoses

W. Yong Kim, Peter G. Danias, Matthias Stuber, Scott D. Flamm, Sven Plein, Eike Nagel, Susan E. Langerak, Oliver M. Weber, Erik M. Pedersen, Matthias Schmidt, René M. Botnar, Warren J. Manning

Research output: Contribution to journalArticle

Abstract

Background An accurate, noninvasive technique for the diagnosis of coronary disease would be an important advance. We investigated the accuracy of coronary magnetic resonance angiography among patients with suspected coronary disease in a prospective, multicenter study. Methods Coronary magnetic resonance angiography was performed during free breathing in 109 patients before elective x-ray coronary angiography, and the results of the two diagnostic procedures were compared. Results A total of 636 of 759 proximal and middle segments of coronary arteries (84 percent) were interpretable on magnetic resonance angiography. In these segments, 78 (83 percent) of 94 clinically significant lesions (those with a ≥50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. Conclusions Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main cor-onary artery or three-vessel disease.

Original languageEnglish (US)
Pages (from-to)1863-1869
Number of pages7
JournalNew England Journal of Medicine
Volume345
Issue number26
StatePublished - 2001
Externally publishedYes

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Magnetic Resonance Angiography
Coronary Stenosis
Coronary Angiography
Confidence Intervals
Coronary Artery Disease
X-Rays
Coronary Disease
Coronary Vessels
Angiography
Arteries
Multicenter Studies
Respiration
Prospective Studies
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kim, W. Y., Danias, P. G., Stuber, M., Flamm, S. D., Plein, S., Nagel, E., ... Manning, W. J. (2001). Coronary magnetic resonance angiography for the detection of coronary stenoses. New England Journal of Medicine, 345(26), 1863-1869.

Coronary magnetic resonance angiography for the detection of coronary stenoses. / Kim, W. Yong; Danias, Peter G.; Stuber, Matthias; Flamm, Scott D.; Plein, Sven; Nagel, Eike; Langerak, Susan E.; Weber, Oliver M.; Pedersen, Erik M.; Schmidt, Matthias; Botnar, René M.; Manning, Warren J.

In: New England Journal of Medicine, Vol. 345, No. 26, 2001, p. 1863-1869.

Research output: Contribution to journalArticle

Kim, WY, Danias, PG, Stuber, M, Flamm, SD, Plein, S, Nagel, E, Langerak, SE, Weber, OM, Pedersen, EM, Schmidt, M, Botnar, RM & Manning, WJ 2001, 'Coronary magnetic resonance angiography for the detection of coronary stenoses', New England Journal of Medicine, vol. 345, no. 26, pp. 1863-1869.
Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E et al. Coronary magnetic resonance angiography for the detection of coronary stenoses. New England Journal of Medicine. 2001;345(26):1863-1869.
Kim, W. Yong ; Danias, Peter G. ; Stuber, Matthias ; Flamm, Scott D. ; Plein, Sven ; Nagel, Eike ; Langerak, Susan E. ; Weber, Oliver M. ; Pedersen, Erik M. ; Schmidt, Matthias ; Botnar, René M. ; Manning, Warren J. / Coronary magnetic resonance angiography for the detection of coronary stenoses. In: New England Journal of Medicine. 2001 ; Vol. 345, No. 26. pp. 1863-1869.
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abstract = "Background An accurate, noninvasive technique for the diagnosis of coronary disease would be an important advance. We investigated the accuracy of coronary magnetic resonance angiography among patients with suspected coronary disease in a prospective, multicenter study. Methods Coronary magnetic resonance angiography was performed during free breathing in 109 patients before elective x-ray coronary angiography, and the results of the two diagnostic procedures were compared. Results A total of 636 of 759 proximal and middle segments of coronary arteries (84 percent) were interpretable on magnetic resonance angiography. In these segments, 78 (83 percent) of 94 clinically significant lesions (those with a ≥50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. Conclusions Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main cor-onary artery or three-vessel disease.",
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AU - Kim, W. Yong

AU - Danias, Peter G.

AU - Stuber, Matthias

AU - Flamm, Scott D.

AU - Plein, Sven

AU - Nagel, Eike

AU - Langerak, Susan E.

AU - Weber, Oliver M.

AU - Pedersen, Erik M.

AU - Schmidt, Matthias

AU - Botnar, René M.

AU - Manning, Warren J.

PY - 2001

Y1 - 2001

N2 - Background An accurate, noninvasive technique for the diagnosis of coronary disease would be an important advance. We investigated the accuracy of coronary magnetic resonance angiography among patients with suspected coronary disease in a prospective, multicenter study. Methods Coronary magnetic resonance angiography was performed during free breathing in 109 patients before elective x-ray coronary angiography, and the results of the two diagnostic procedures were compared. Results A total of 636 of 759 proximal and middle segments of coronary arteries (84 percent) were interpretable on magnetic resonance angiography. In these segments, 78 (83 percent) of 94 clinically significant lesions (those with a ≥50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. Conclusions Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main cor-onary artery or three-vessel disease.

AB - Background An accurate, noninvasive technique for the diagnosis of coronary disease would be an important advance. We investigated the accuracy of coronary magnetic resonance angiography among patients with suspected coronary disease in a prospective, multicenter study. Methods Coronary magnetic resonance angiography was performed during free breathing in 109 patients before elective x-ray coronary angiography, and the results of the two diagnostic procedures were compared. Results A total of 636 of 759 proximal and middle segments of coronary arteries (84 percent) were interpretable on magnetic resonance angiography. In these segments, 78 (83 percent) of 94 clinically significant lesions (those with a ≥50 percent reduction in diameter on x-ray angiography) were also detected by magnetic resonance angiography. Overall, coronary magnetic resonance angiography had an accuracy of 72 percent (95 percent confidence interval, 63 to 81 percent) in diagnosing coronary artery disease. The sensitivity, specificity, and accuracy for patients with disease of the left main coronary artery or three-vessel disease were 100 percent (95 percent confidence interval, 97 to 100 percent), 85 percent (95 percent confidence interval, 78 to 92 percent), and 87 percent (95 percent confidence interval, 81 to 93 percent), respectively. The negative predictive values for any coronary artery disease and for left main artery or three-vessel disease were 81 percent (95 percent confidence interval, 73 to 89 percent) and 100 percent (95 percent confidence interval, 97 to 100 percent), respectively. Conclusions Among patients referred for their first x-ray coronary angiogram, three-dimensional coronary magnetic resonance angiography allows for the accurate detection of coronary artery disease of the proximal and middle segments. This noninvasive approach reliably identifies (or rules out) left main cor-onary artery or three-vessel disease.

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