Comparison of ultrafast dipyridamole magnetic resonance imaging with dipyridamole sestamibi SPECT for detection of perfusion abnormalities in patients with one‐vessel coronary artery disease: Assessment by quantitative model fitting

Abstract

The value of ultrafast MRI for detection of myocardial perfusion abnormalities in patients with coronary artery disease (CAD) was assessed in 10 patients with stable angina pectoris and angiographically proven one-vessel CAD using double-level short-axis ultrafast MRI with bolus injection of gadolinium-DTPA and tomographic technetium-99m SestaMIBI imaging (SPECT) during dipyridamole-induced coronary hyperemia. Abnormally perfused regions were assessed with SPECT and MRI in all (100%) patients. Agreement in localization between arteriography and SPECT was 80%; between arteriography and MR, 70%; and between SPECT and MR, 90%. The signal intensity increase after the bolus injection of gadolinium-DTPA using a linear fit, and the slope of gadolinium-DTPA wash-in using double exponential model fitting were significantly different between abnormally and normally perfused regions. These preliminary results demonstrate the potential of dipyridamole ultrafast MR to monitor stress-induced flow maldistribution in patients with single vessel CAD.

Myocardial Perfusion Magnetic Resonance Imaging for Diagnosing Coronary Arterial Stenosis

“…1,3) In the present study, the mean values of t-peak did not differ significantly between normal and ischemic regions, probably because the time resolution was limited. Since MR images were acquired at 3-4 second intervals, changes in SI under 4 seconds or shorter were not reflected in the results.…”

“…3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The diagnostic accuracy of myocardial perfusion MRI may vary depending on the strength of the magnetic field, pulse sequences, and time resolution of the MRI apparatus, the number of acquired MR images, and the severity of coronary arterial lesions. However, it has been reported that suitable diagnostic accuracy was obtained using a 0.5-1.0 Tesla MRI apparatus, as Keijer, et al 21) reported that the accuracy of a 1.0 Tesla MRI apparatus for diagnosing ischemic heart disease did not significantly differ from that of a 1.5 Tesla MRI apparatus.…”

Multislice first‐pass myocardial perfusion imaging: Comparison of saturation recovery (SR)‐TrueFISP‐two‐dimensional (2D) and SR‐TurboFLASH‐2D pulse sequences

“…Another issue is the incomplete coverage of the left ventricle. In most previous studies, only one or two slices could be acquired simultaneously without compromising spatial or temporal resolution (one image/heartbeat) (11)(12)(13).…”

Myocardial perfusion imaging by cardiac magnetic resonance

“…In the past an inversion recovery preparation was most often used, 6,8,9,17,[26][27][28] because it provides a large dynamic range of signal response, theoretically from negative to positive longitudinal magnetizations ϪM z to ϩM z . However, in practice the delay time from preparation to readout was selected to obtain near-zero magnetization before the start of readout, which required 300 to 400 milliseconds of waiting time, thus precluding true multislice imaging.…”

“…Whereas absolute quantification of perfusion is still challenging and not all issues are resolved, the quantification of perfusion-related parameters appears best suited to serve as an interstudy standard. Perfusion-related parameters have been applied widely and are, for example, the upslope of signal during first-pass conditions, 7,10,13,14,17,26,29,33 the maximum signal during the first pass, 6,8,14,54,60 the time to peak, the mean transit time, 7,14,53 the area under the signal intensity-time curve, 61 and many others. Before an analysis algorithm is applied, the perfusion data are typically registered-that is, motion resulting from a drift of the diaphragm or even from breathing is eliminated by shifting the images in the time series, which can be achieved by hand or by means of algorithms.…”