Diagnostic accuracy of stress myocardial perfusion MRI and late gadolinium-enhanced MRI for detecting flow-limiting coronary artery disease: a multicenter study |
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Authors: | Kakuya Kitagawa Hajime Sakuma Motonori Nagata Shigeo Okuda Masaharu Hirano Akihiro Tanimoto Masaki Matsusako Joao A C Lima Sachio Kuribayashi Kan Takeda |
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Institution: | (1) Department of Radiology, Mie University Hospital, 2–174 Edobashi, Tsu Mie, 514–8507, Japan;(2) Department of Radiology, Keio University School of Medicine, Tokyo, Japan;(3) Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan;(4) Department of Radiology, St. Luke’s International Hospital, Tokyo, Japan;(5) Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA |
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Abstract: | The aim of this study was to determine the diagnostic performance of stress and rest perfusion magnetic resonance imaging
(MRI) and late gadolinium-enhanced (LGE) MRI for identifying patients with obstructive coronary artery disease (CAD). A total
of 50 patients with suspected CAD underwent stress-rest perfusion MRI, followed by LGE MRI with a 1.5-T system. Stress-rest
perfusion MRI resulted in an area under the receiver-operating characteristic curve (AUC) of 0.92 for observer 1 and 0.84
for observer 2 with sensitivity and specificity of 89% (32/36) and 79% (11/14) by observer 1, 83% (30/36) and 71% (10/14)
by observer 2, respectively, showing a moderate interobserver agreement (Cohen’s κ = 0.49). While combination of stress-rest
perfusion and LGE MRI did not result in improved accuracy for the prediction of flow-limiting obstructive CAD (AUC 0.81 for
observer 1 and 0.80 for observer 2), the sensitivity was increased to 92% in both observers with a substantial interobserver
agreement (κ = 0.70). Stress-rest myocardial perfusion MRI is an accurate diagnostic test for identifying patients with obstructive
CAD. |
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Keywords: | Coronary artery disease Multicenter trial Myocardial perfusion Magnetic resonance imaging Pharmacological stress |
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