Accelerated 3D whole-heart non-contrast-enhanced mDIXON coronary MR angiography using deep learning-constrained compressed sensing reconstruction

To investigate the feasibility of a deep learning-constrained compressed sensing (DL-CS) method in non-contrast-enhanced modified DIXON (mDIXON) coronary magnetic resonance angiography (MRA) and compare its diagnostic accuracy using coronary CT angiography (CCTA) as a reference standard. Ninety-nine participants were prospectively recruited for this study. Thirty healthy subjects (age range: 20–65 years; 50% female) underwent three non-contrast mDIXON-based coronary MRA sequences including DL-CS, CS, and conventional sequences. The three groups were compared based on the scan time, subjective image quality score, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The remaining 69 patients suspected of coronary artery disease (CAD) (age range: 39–83 years; 51% female) underwent the DL-CS coronary MRA and its diagnostic performance was compared with that of CCTA. The scan time for the DL-CS and CS sequences was notably shorter than that of the conventional sequence (9.6 ± 3.1 min vs 10.0 ± 3.4 min vs 13.0 ± 4.9 min; p < 0.001). The DL-CS sequence obtained the highest image quality score, mean SNR, and CNR compared to CS and conventional methods (all p < 0.001). Compared to CCTA, the accuracy, sensitivity, and specificity of DL-CS mDIXON coronary MRA per patient were 84.1%, 92.0%, and 79.5%; those per vessel were 90.3%, 82.6%, and 92.5%; and those per segment were 98.0%, 85.1%, and 98.0%, respectively. The DL-CS mDIXON coronary MRA provided superior image quality and short scan time for visualizing coronary arteries in healthy individuals and demonstrated high diagnostic value compared to CCTA in CAD patients. DL-CS resulted in improved image quality with an acceptable scan time, and demonstrated excellent diagnostic performance compared to CCTA, which could be an alternative to enhance the workflow of coronary MRA.