Compressed Sensing‐Accelerated 3.0 T Noncontrast‐Enhanced CMRA: Diagnostic Efficacy for Coronary Artery Stenosis

Coronary artery disease is a leading cause of cardiovascular death. Conventional noncontrast‐enhanced 3.0 T coronary magnetic resonance angiography (CMRA) is safe but limited by long scan times and motion artifacts. Compressed sensing (CS) can accelerate imaging, yet the optimal acceleration factor remains undefined. This study aimed to evaluate the diagnostic accuracy of 4.5‐fold CS (4.5 × CS)‐accelerated 3.0 T noncontrast‐enhanced CMRA for detecting coronary artery stenosis, using invasive coronary angiography as the reference standard.

Thirty patients with suspected coronary artery disease who underwent CMRA, coronary computed tomography angiography, and invasive coronary angiography at the Affiliated Hospital of Guizhou Medical University from December 2022 to November 2024 were enrolled. The diagnostic performance of CMRA for detecting ≥ 50.00% stenosis was evaluated using the kappa test (agreement), Wilcoxon signed‐rank test (continuous variables), and calculations of sensitivity, specificity, and accuracy.

The 4.5 × CS protocol shortened CMRA scan time by 52.30% (to [7.2 ± 1.3] min) while maintaining image quality (signal‐to‐noise ratio, 25.3–30.2; contrast‐to‐noise ratio, 19.6–24.5). CMRA showed excellent agreement with invasive coronary angiography (kappa = 0.905, p < 0.001), with strong diagnostic performance at the segment level (sensitivity 86.90%, specificity 99.01%, accuracy 95.45%), the vessel level (sensitivity 94.59%, accuracy 79.17%), and the patient level (sensitivity 92.00%, accuracy 90.00%).

4.5 × CS‐accelerated 3.0 T noncontrast‐enhanced CMRA achieves a favorable balance between efficiency, image quality, and diagnostic accuracy. As a radiation‐ and contrast‐free modality, it may be particularly valuable for coronary artery disease screening and follow‐up (e.g., in contrast‐allergic or renally impaired patients) and shows strong potential for clinical translation.