Diagnostic Performance of Stress Cardiac Magnetic Resonance Imaging in the Detection of Coronary Artery Disease. A Meta-Analysis

Kiran R. Nandalur, Ben A. Dwamena, Asim Choudhri, Mohan R. Nandalur, Ruth C. Carlos

Research output: Contribution to journalArticle

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Abstract

Objectives: The purpose of our study was to conduct an evidence-based evaluation of stress cardiac magnetic resonance imaging (MRI) in the diagnosis of coronary artery disease (CAD). Background: Stress cardiac MRI has recently emerged as a noninvasive method in the detection of CAD, with 2 main techniques in use: 1) perfusion imaging; and 2) stress-induced wall motion abnormalities imaging. Methods: We examined studies from January 1990 to January 2007 using MEDLINE and EMBASE. A study was included if it: 1) used stress MRI as a diagnostic test for CAD (≥50% diameter stenosis); and 2) used catheter X-ray angiography as the reference standard. Results: Thirty-seven studies (2,191 patients) met the inclusion criteria, with 14 datasets (754 patients) using stress-induced wall motion abnormalities imaging and 24 datasets (1,516 patients) using perfusion imaging. Stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 (95% confidence interval [CI] 0.79 to 0.88) and specificity of 0.86 (95% CI 0.81 to 0.91) on a patient level (disease prevalence = 70.5%). Perfusion imaging demonstrated a sensitivity of 0.91 (95% CI 0.88 to 0.94) and specificity of 0.81 (95% CI 0.77 to 0.85) on a patient level (disease prevalence = 57.4%). Conclusions: In studies with high disease prevalence, stress cardiac MRI, using either technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD. However, limited data are available regarding use of either technique in populations with low disease prevalence.

Original languageEnglish (US)
Pages (from-to)1343-1353
Number of pages11
JournalJournal of the American College of Cardiology
Volume50
Issue number14
DOIs
StatePublished - Oct 1 2007
Externally publishedYes

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Meta-Analysis
Coronary Artery Disease
Magnetic Resonance Imaging
Perfusion Imaging
Confidence Intervals
Routine Diagnostic Tests
MEDLINE
Angiography
Pathologic Constriction
Catheters
X-Rays
Sensitivity and Specificity
Population
Datasets

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Diagnostic Performance of Stress Cardiac Magnetic Resonance Imaging in the Detection of Coronary Artery Disease. A Meta-Analysis. / Nandalur, Kiran R.; Dwamena, Ben A.; Choudhri, Asim; Nandalur, Mohan R.; Carlos, Ruth C.

In: Journal of the American College of Cardiology, Vol. 50, No. 14, 01.10.2007, p. 1343-1353.

Research output: Contribution to journalArticle

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abstract = "Objectives: The purpose of our study was to conduct an evidence-based evaluation of stress cardiac magnetic resonance imaging (MRI) in the diagnosis of coronary artery disease (CAD). Background: Stress cardiac MRI has recently emerged as a noninvasive method in the detection of CAD, with 2 main techniques in use: 1) perfusion imaging; and 2) stress-induced wall motion abnormalities imaging. Methods: We examined studies from January 1990 to January 2007 using MEDLINE and EMBASE. A study was included if it: 1) used stress MRI as a diagnostic test for CAD (≥50{\%} diameter stenosis); and 2) used catheter X-ray angiography as the reference standard. Results: Thirty-seven studies (2,191 patients) met the inclusion criteria, with 14 datasets (754 patients) using stress-induced wall motion abnormalities imaging and 24 datasets (1,516 patients) using perfusion imaging. Stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 (95{\%} confidence interval [CI] 0.79 to 0.88) and specificity of 0.86 (95{\%} CI 0.81 to 0.91) on a patient level (disease prevalence = 70.5{\%}). Perfusion imaging demonstrated a sensitivity of 0.91 (95{\%} CI 0.88 to 0.94) and specificity of 0.81 (95{\%} CI 0.77 to 0.85) on a patient level (disease prevalence = 57.4{\%}). Conclusions: In studies with high disease prevalence, stress cardiac MRI, using either technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD. However, limited data are available regarding use of either technique in populations with low disease prevalence.",
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