Intraindividual comparison of contrast-enhanced electron-beam computed tomography and navigator-echo-based magnetic resonance imaging for noninvasive coronary artery angiography

The aim of this study was to compare contrast-enhanced electron-beam computed tomography (EBCT) and navigator-echo-based MRI of the coronary arteries in the same patient population. Both methods were assessed for visualization of the coronary arteries and their diagnostic accuracy in identifying significant coronary artery stenoses compared with conventional coronary angiography. Twenty patients with known coronary artery disease were examined with both contrast-enhanced EBCT and a respiratory-gated MRI sequence. A grading system was used to evaluate the image quality. Sensitivity and specificity for the detection of significant coronary artery stenoses was evaluated compared with conventional coronary angiography. With EBCT, 89% of the main coronary arteries could be completely visualised in the proximal and middle segments; with MRI, 83% were visualised. With EBCT the sensitivities for identifying significant (>/=50%) stenoses in proximal and middle vessel segments were 75% in the main stem, 88% in the left anterior descending coronary artery, 75% in the left circumflex coronary artery, and 90% in the right coronary artery. Respective sensitivities for MRI angiograms were 75, 82, 75 and 80%. With both modalities a sufficient image quality of the main coronary arteries can be obtained in most cases. The diagnostic capability for detecting significant stenoses is comparable for both methods.