Background Whole-heart coronary MR angiography (MRA) is a promising method for

Background Whole-heart coronary MR angiography (MRA) is a promising method for noninvasive, radiation-free detection and exclusion of obstructive coronary artery disease (CAD); however, the required imaging time and robustness of the technique are not yet satisfactory. of coronary MRA was successfully completed in 101 of 110 (92%) patients with average imaging time of 7.0 1.8 min. The sensitivity, specificity, positive and negative predictive value of coronary MRA on a patient-based analysis were 95.9% (47/49, 95% CI: 86.0% to 99.4%), 86.5% (45/52, 95% CI, 74.2% to 94.4%), 87.0% (47/54, 95% CI, 75.1% to 94.6%) and 95.7% (45/47, 95% CI, 85.4% to 99.4%), respectively. Conclusions Whole-heart coronary MRA at 3.0 T using a 32-channal cardiac coil allows high overall accuracy for detecting significant CAD with reduced imaging time. It has potential to be a robust and alternative technique for ruling out significant CAD. Clinical Trial Registration URL: Unique identifier: ChiCTR-DDT-07000121. Keywords: magnetic resonance angiography, coronary arteries, 3.0 T The current gold standard for the assessment of coronary artery disease (CAD) remains invasive X-ray coronary angiography, which exposes patients to ionizing radiation and involves certain risk of complications. Since the implementation of multi-slice CT (MSCT), non-invasive coronary imaging using 64-slice CT has proven to be highly accurate as a diagnostic tool for the detection of coronary artery stenoses in the clinical routine1, 2. However, radiation exposure to patients and its possible risk CUDC-907 of cancer induction have remained issues of great concern3. Over the past 15 years, the continuous improvement in MRI technology allows noninvasive, radiation-free, comprehensive evaluation of CAD4-6. Initial experiences have shown that the diagnostic accuracy of contrast-enhanced whole-heart coronary MRA at 3.0T in detecting coronary artery stenosis approaches that of 64-slice CT7. Nevertheless, coronary MR angiography (MRA) procedure remains lengthy and has limited the general applicability of this test8, 9. Further reductions in CUDC-907 coronary MRA acquisition time have been made possible recently with the novel multi-channel cardiac coils and high parallel imaging factors10. The use of parallel imaging at higher CUDC-907 magnetic fields has been shown to be extremely promising for minimizing the many challenges for high-resolution, high-speed coronary MRA. We have therefore conducted a prospective study to evaluate the diagnostic performance of 3.0 T whole-heart coronary MRA using a DGKH 32-channal cardiac coil compared with quantitative X-ray coronary angiography in patients with suspected CAD. Methods Study Population From January 2009 to July 2010, a total of 130 consecutive patients scheduled for conventional coronary angiography were prospectively recruited in this study. Exclusion criteria included general contraindications to MR examination (claustrophobia, pacemaker), unstable angina, atrial fibrillation, patients with coronary stents or bypass grafts, and renal insufficiency (estimated glomerular filtration rate assessed by creatinine clearance < 60 ml/min/1.73 m2). 20 patients were excluded for these reasons and 110 patients (54 men, age 58 11) underwent coronary MRA before conventional coronary angiography (Figure 1). The study protocol was approved by the institutional review board of our hospital. Written informed consent was obtained from each patient prior to the study. Figure 1 Flow Diagram of Patient Recruitment Patient Preparation A beta-blocker (metoprolol tartrate, 25 to 50 mg) was given orally to patients with heart rate >75 beats/min before coronary MRA. All images were collected under free breathing with the patient in supine position. Patients were trained to perform shallow breathing during coronary MRA data acquisition. Abdominal belt was wrapped non-tightly in patients with irregular breath pattern to suppress the vertical motion of the diaphragm. Acquisition of 3.0T Whole-Heart Coronary MRA CUDC-907 with 32-Channel Cardiac Coils Contrast-enhanced whole-heart coronary MRA was performed on a 3.0T whole-body scanner (MAGNETOM Trio; Siemens AG Healthcare, Germany) with a 32-channel cardiac coil (Invivo, Gainesville, Florida, USA). The procedures were as follows: Two dimensional (2D) scout images were first obtained in three orthogonal orientations to identify.

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