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Coronary MR Angiography: Comparison of Quantitative and Qualitative Data from Four Techniques

¹ Department of Medicine (Cardiovascular Division) and Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
² Present address: Department of Clinical Radiology, University of Münster, Albert-Schweitzer-Strasse 33, Münster 48129, Germany.
³ Philips Medical Systems, Best, The Netherlands.

OBJECTIVE. The optimal coronary MR angiography sequence has yet to be determined. We sought to quantitatively and qualitatively compare four coronary MR angiography sequences.

SUBJECTS AND METHODS. Free-breathing coronary MR angiography was performed in 12 patients using four imaging sequences (turbo field-echo, fast spin-echo, balanced fast field-echo, and spiral turbo field-echo). Quantitative comparisons, including signal-to-noise ratio, contrast-to-noise ratio, vessel diameter, and vessel sharpness, were performed using a semiautomated analysis tool. Accuracy for detection of hemodynamically significant disease (> 50%) was assessed in comparison with radiographic coronary angiography.

RESULTS. Signal-to-noise and contrast-to-noise ratios were markedly increased using the spiral (25.7 ± 5.7 and 15.2 ± 3.9) and balanced fast field-echo (23.5 ± 11.7 and 14.4 ± 8.1) sequences compared with the turbo field-echo (12.5 ± 2.7 and 8.3 ± 2.6) sequence (p < 0.05). Vessel diameter was smaller with the spiral sequence (2.6 ± 0.5 mm) than with the other techniques (turbo field-echo, 3.0 ± 0.5 mm, p = 0.6; balanced fast field-echo, 3.1 ± 0.5 mm, p < 0.01; fast spin-echo, 3.1 ± 0.5 mm, p < 0.01). Vessel sharpness was highest with the balanced fast field-echo sequence (61.6% ± 8.5% compared with turbo field-echo, 44.0% ± 6.6%; spiral, 44.7% ± 6.5%; fast spin-echo, 18.4% ± 6.7%; p < 0.001). The overall accuracies of the sequences were similar (range, 74% for turbo field-echo, 79% for spiral). Scanning time for the fast spin-echo sequences was longest (10.5 ± 0.6 min), and for the spiral acquisitions was shortest (5.2 ± 0.3 min).

CONCLUSION. Advantages in signal-to-noise and contrast-to-noise ratios, vessel sharpness, and the qualitative results appear to favor spiral and balanced fast field-echo coronary MR angiography sequences, although subjective accuracy for the detection of coronary artery disease was similar to that of other sequences.

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