Clinical evaluation of magnetic resonance imaging in coronary heart disease: The CE-MARC study

被引：47

作者：

Greenwood, John P. ^{[1
]}

Maredia, Neil ^{[1
]}

Radjenovic, Aleksandra ^{[2
]}

Brown, Julia M. ^{[3
]}

Nixon, Jane ^{[3
]}

Farrin, Amanda J. ^{[3
]}

Dickinson, Catherine ^{[4
]}

Younger, John F. ^{[1
]}

Ridgway, John P. ^{[5
]}

Sculpher, Mark ^{[6
]}

Ball, Stephen G. ^{[1
]}

Plein, Sven ^{[1
]}

机构：

[1] Univ Leeds, Leeds Gen Infirm, Leeds Inst Genet Hlth & Therapeut, Div Cardiovasc & Neuronal Remodelling, Leeds LS1 3EX, W Yorkshire, England

[2] Univ Leeds, Div Med Phys, Leeds LS2 9JT, W Yorkshire, England

[3] Univ Leeds, Clin Trials Res Unit, Leeds LS2 9PH, W Yorkshire, England

[4] Leeds Gen Infirm, Leeds Teaching Hosp NHS Trust, Dept Nucl Cardiol, Leeds LS1 3EX, W Yorkshire, England

[5] Leeds Teaching Hosp NHS Trust, Dept Med Phys, Leeds LS2 9JT, W Yorkshire, England

[6] Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England

来源：

TRIALS | 2009年 / 10卷

关键词：

ARTERY-DISEASE; COST-EFFECTIVENESS; RISK; MRI; UK;

D O I：

10.1186/1745-6215-10-62

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

100103 [病原生物学]; 100218 [急诊医学];

摘要：

Background: Several investigations are currently available to establish the diagnosis of coronary heart disease (CHD). Of these, cardiovascular magnetic resonance (CMR) offers the greatest information from a single test, allowing the assessment of myocardial function, perfusion, viability and coronary artery anatomy. However, data from large scale studies that prospectively evaluate the diagnostic accuracy of multi-parametric CMR for the detection of CHD in unselected populations are lacking, and there are few data on the performance of CMR compared with current diagnostic tests, its prognostic value and cost-effectiveness. Methods/design: This is a prospective diagnostic accuracy cohort study of 750 patients referred to a cardiologist with suspected CHD. Exercise tolerance testing (ETT) will be preformed if patients are physically able. Recruited patients will then undergo CMR and single photon emission tomography (SPECT) followed in all patients by invasive X-ray coronary angiography. The order of the CMR and SPECT tests will be randomised. The CMR study will comprise rest and adenosine stress perfusion, cine imaging, late gadolinium enhancement and whole-heart MR coronary angiography. SPECT will use a gated stress/rest protocol. The primary objective of the study is to determine the diagnostic accuracy of CMR in detecting significant coronary stenosis, as defined by Xray coronary angiography. Secondary objectives include an assessment of the prognostic value of CMR imaging, a comparison of its diagnostic accuracy against SPECT and ETT, and an assessment of cost-effectiveness. Discussion: The CE-MARC study is a prospective, diagnostic accuracy cohort study of 750 patients assessing the performance of a multi-parametric CMR study in detecting CHD using invasive X-ray coronary angiography as the reference standard and comparing it with ETT and SPECT.

引用

页数：9

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