Detection of coronary artery disease by magnetic resonance myocardial perfusion imaging with various contrast medium doses: first european multi-centre experience

Abstract

With increasing doses of CM, a higher signal response in the myocardium was achieved and consequently this stress-only protocol, with CM doses of 0.10-0.15 mmol/kg combined with a semi-automatic analysis, yielded a high diagnostic performance for the detection of CAD.

I Diretriz de Ressonância e Tomografia Cardiovascular da Sociedade Brasileira de Cardiologia Sumário Executivo

“…A pesquisa de isquemia pela avaliação da perfusão miocárdica utiliza na rotina clínica a avaliação qualitativa da passagem do contraste pelo miocárdio após sua injeção em veia periférica 24 . Obtém-se imagens na fase de estresse induzido com dipiridamol ou adenosina e na fase de repouso, com boa acurácia diagnóstica em relação à cinecoronariografia invasiva, à tomografia de emissão de pósitrons (PET) e à cintilografia miocárdica perfusional (SPECT) 25 .…”

Cardiac magnetic resonance imaging in patients with coronary disease

“…However, in a more recent multicenter study, the specificity was not as high (75%), although stress imaging without rest imaging was used in this study [11]. The drawback of a quantitative approach at present is that it is quite time consuming and not feasible for routine clinical use.…”

The emerging clinical role of cardiovascular magnetic resonance imaging

“…It is commonly believed that adenosine causes a 'steal phenomenon' by increasing perfusion in coronary territories not affected by epicardial artery stenosis, which leads to relative hypoperfusion of the territory subtended by a stenosed coronary artery (33). Several research papers (34)(35)(36)(37)(38), including one multicentre study, have assessed the role of adenosine stress perfusion for the diagnosis of coronary artery disease and consistently demonstrated high sensitivity for CMR imaging to diagnose epicardial coronary artery stenoses. When CMR perfusion was compared with x-ray coronary angiography, its specificities to detect coronary stenoses were only moderately high (62% to 90%) (34)(35)(36)(37)(38).…”

“…Several research papers (34)(35)(36)(37)(38), including one multicentre study, have assessed the role of adenosine stress perfusion for the diagnosis of coronary artery disease and consistently demonstrated high sensitivity for CMR imaging to diagnose epicardial coronary artery stenoses. When CMR perfusion was compared with x-ray coronary angiography, its specificities to detect coronary stenoses were only moderately high (62% to 90%) (34)(35)(36)(37)(38). However, when PET or fractional flow reserve on x-ray angiography were used as standards of truth, specificities were higher (94% [34] and 90% [38], respectively).…”