Diagnostic accuracy of magnetic resonance angiography for detection of coronary artery disease: a systematic review and meta-analysis

Giovanni Di Leo, Erica Fisci, Francesco Secchi, Marco Alì, Federico Ambrogi, Luca Maria Sconfienza, Francesco Sardanelli

Research output: Contribution to journalArticle

Abstract

Objectives: To review the diagnostic performance of MR coronary angiography (MRCA) for coronary artery disease (CAD). Methods: Two independent reviewers searched on MEDLINE/EMBASE with the following inclusion criteria: 01/01/2000-03/23/2015 publication date; per-patient sensitivity/specificity for >50 % stenosis confirmed by conventional coronary angiography with raw data provided or retrievable; sample size >10. Quality was appraised using QUADAS2. Results: Nine hundred eighteen studies were retrieved, 24 of them, including 1,638 patients, were selected. Using a bivariate model, the pooled sensitivity was 89 % (95 % confidence interval 86–92 %), the pooled specificity 72 % (63–79 %). Meta-regression did not show a significant impact on sensitivity/specificity for both year of publication and disease prevalence (p ≥ 0.114). Sensitivity of contrast-enhanced examinations (95 %, 90–97 %) was higher (p = 0.005) than that of unenhanced examinations (87 %, 83–90 %). Specificity of whole-heart acquisition mode (78 %, 72–84 %) was higher (p = 0.006) than that of targeted mode (57 %, 45–69 %). Specificity at 3 T (83 %, 69–92 %) was higher (p = 0.067) than that at 1.5 T (68 %, 60–76 %). Risk of bias and concerns regarding applicability were low. Conclusions: Sensitivity and specificity of MRCA for CAD were 89 % and 72 %, respectively. A specificity higher than 80 % may be obtained at 3 T. Whole-heart contrast-enhanced protocols should be preferred for a higher diagnostic performance. Key Points: • MRCA sensitivity and specificity for CAD are below those of CTA. • Contrast administration increased sensitivity to 95 % (90–97 %), comparable with that of CTA. • Whole-heart mode increased specificity to 78 % (72–84 %), comparable with that of CTA. • Specificity at 3 T was borderline-significantly higher (p = 0.067) than at 1.5 T. • Whole-heart contrast-enhanced protocols are the best approach for MRCA.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalEuropean Radiology
DOIs
Publication statusAccepted/In press - Dec 11 2015

Keywords

  • Coronary angiography
  • Coronary artery disease
  • Diagnostic accuracy
  • Magnetic resonance imaging
  • Meta-analysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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