Background Coronary MR angiography (CMRA) at 3 T offers higher signal to noise ratio and contrast to noise ratio compared with 1.5 T. CMRA at 5 T may provide better diagnostic performance. Purpose To assess the feasibility and clinical application of 5-T noncontrast whole-heart CMRA and compare 5-T acquisition with 3-T acquisition. Materials and Methods From September 2023 to April 2024, patients scheduled for coronary CT angiography (CCTA) and volunteers were prospectively recruited. CCTA served as the reference standard in patients. CMRA was performed using a 3-T spectral attenuated inversion-recovery (3TSPAIR) sequence and 3-T Dixon (3TDixon) sequence with routine spatial resolution (3TSPAIR-routine and 3TDixon-routine, respectively), and 5-T Dixon (5TDixon) with routine and high spatial resolution (5TDixon-routine and 5TDixon-high, respectively). The study evaluated image quality, coronary artery calcium (CAC), the severity of coronary artery disease (CAD) graded according to Coronary Artery Disease Reporting and Data System, and the presence of ≥50% coronary stenosis. The nonparametric paired Wilcoxon signed rank test, McNemar test, generalized estimating equation model, and kappa test were used. Results Eight volunteers and 79 patients were included (mean age, 52 years ± 11 [SD]; 48 male). Image quality was higher for 5TDixon-routine compared with 3TSPAIR-routine and 3TDixon-routine (P < .001 for both) and similar for 5TDixon-high (P = .60). The per-segment sensitivity for CAC was higher at 5TDixon-high than 5TDixon-routine (78.3% vs 53.3%; P < .001), with no difference in specificity (98.6% vs 98.6%; P > .99). In grading the severity of CAD, 5TDixon-routine showed better consistency with CCTA than 3TSPAIR-routine (κ = 0.46 vs 0.13) and 3TDixon-routine (κ = 0.55 vs 0.42). For detecting ≥50% stenosis, the per-patient sensitivity, specificity, and accuracy were as follows: 5TDixon-routine versus 3TSPAIR-routine, 88.9% versus 55.6%, 86.5% versus 62.2%, and 87.0% versus 60.9% (P = .55, .01, and .18, respectively); 5TDixon-routine versus 3TDixon-routine, 90.0% versus 80.0%, 86.8% versus 71.1%, and 87.5% versus 72.9%, respectively (P > .05 for all). Conclusion Noncontrast CMRA at 5 T shows potential to evaluate CAC and coronary stenosis simultaneously and demonstrates superior diagnostic performance compared with at 3 T. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Rahsepar and Kim in this issue.

中文翻译：

---

5-T 平扫 Dixon 全心冠状动脉 MR 血管造影的可行性和临床应用：一项前瞻性研究。


背景：与 1.5 T 相比，3 T 的冠状动脉 MR 血管造影 （CMRA） 提供更高的信噪比和对比度噪声比。目的 评价 5-T 平扫全心 CMRA 的可行性和临床应用，并将 5-T 采集与 3-T 采集进行比较。材料和方法 从 2023 年 9 月至 2024 年 4 月，前瞻性招募计划进行冠状动脉 CT 血管造影 （CCTA） 的患者和志愿者。CCTA 作为患者的参考标准。使用具有常规空间分辨率 （分别为 3TSPAIR-常规和 3TDixon-常规） 的 3-T 光谱衰减反转恢复 （3TSPAIR-常规和 3TDixon-常规） 和 5-T Dixon （5TDixon） 具有常规和高空间分辨率 （分别为 5TDixon-常规和 5TDixon-high） 的 3-T Dixon （5TDixon） 序列进行 CMRA。该研究评估了图像质量、冠状动脉钙化 （CAC）、根据冠状动脉疾病报告和数据系统分级的冠状动脉疾病 （CAD） 的严重程度，以及是否存在 ≥50% 的冠状动脉狭窄。采用非参数配对 Wilcoxon 符号秩检验、 McNemar 检验、广义估计方程模型和 kappa 检验。结果 纳入 8 名志愿者和 79 例患者 （平均年龄 52 岁 ± 11 [SD];48 名男性）。与 3TSPAIR 程序和 3TDixon 程序相比，5TDixon 程序的图像质量更高 （两者的 P < .001），并且 5TDixon-high 的图像质量相似 （P = .60）。CAC 的每段敏感性在 5TDixon 高时高于 5TDixon 常规 （78.3% 对 53.3%;P < .001），特异性无差异 （98.6% vs 98.6%;P > .99）。在 CAD 的严重程度分级中，5TDixon 程序与 CCTA 的一致性优于 3TSPAIR-routine （κ = 0.46 vs 0.13） 和 3TDixon 例程 （κ = 0.55 vs 0.42）。对于检测 ≥50% 狭窄，每位患者的敏感性、特异性和准确性如下：5TDixon 常规与 3TSPAIR 常规、88.9% 对 55.6%、86.5% 对 62.2% 和 87.0% 对 60.9%（分别为 P = .55、.01 和 .18）;5TDixon 程序与 3TDixon 程序，分别为 90.0% 对 80.0%、86.8% 对 71.1% 和 87.5% 对 72.9%（P > .05）。结论 5 T 的非对比 CMRA 显示出同时评估 CAC 和冠状动脉狭窄的潜力，并且与 3 T 相比表现出卓越的诊断性能。© RSNA，2024 本文提供补充材料。另请参见 Rahsepar 和 Kim 在本期的社论。