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

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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)3706-18
Number of pages13
JournalEuropean Radiology
Volume26
Issue number10
DOIs
Publication statusPublished - Oct 2016

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Keywords

  • Contrast Media
  • Coronary Angiography
  • Coronary Artery Disease
  • Coronary Stenosis
  • Humans
  • Magnetic Resonance Angiography
  • Sensitivity and Specificity
  • Journal Article
  • Meta-Analysis
  • Review

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