Diagnostic Accuracy of Stress First-Pass Contrast-Enhanced Myocardial Perfusion MRI Compared with Stress Myocardial Perfusion Scintigraphy

Sakuma, Hajime; Suzawa, Naohisa; Ichikawa, Yasutaka; Makino, Katsutoshi; Hirano, Tadanori; Kitagawa, Kakuya; Takeda, Kan

doi:10.2214/ajr.185.1.01850095

Cited by 102 publications

(57 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our singlecenter studies, the diagnostic accuracy of stress perfusion MRI was superior to that of stress SPECT. 32,33 The area under the ROC curve for detection of significant CAD was 0.84-0.86 for stress perfusion MRI, significantly higher than that of stress perfusion SPECT (0.72-0.79). 32 In a recent multicenter, multivendor prospective trial by Schwitter et al, the diagnostic performance of stress perfusion MRI (area under the ROC curve 0.86±0.06) was better than that of stress perfusion SPECT (0.67±0.05, P=0.003), particularly in patients with 2-and 3-vessel disease.…”

Section: Circulation Journal Vol73 September 2009mentioning

confidence: 94%

Cardiac MRI in Ischemic Heart Disease

Ishida

Kato

Sakuma

2009

Circ J

Self Cite

View full text Add to dashboard Cite

he first ECG-gated magnetic resonance (MR) images of the heart were acquired more than 25 years ago, and MR imaging (MRI) was initially used to evaluate the morphology and motion of the heart. With developments of late gadolinium-enhanced (LGE) MRI and myocardial perfusion MRI, the application of MRI in ischemic heart disease (IHD) has been considerably expanded in the past 10 years. Because MRI has high spatial resolution and excellent image contrast, subendocardial infarction and myocardial ischemia can be clearly visualized. In addition, MRI does not expose the patient to ionizing radiation nor require the administration of iodinated contrast medium, which is potentially nephrotoxic. Coronary MR angiography (MRA) is rapidly evolving and has emerged as a possible alternative to multidetector-row computed tomography (MDCT) for noninvasive visualization of coronary artery disease (CAD). In this review, we describe recent advances of cardiac MRI and coronary MRA, and demonstrate the usefulness of MRI for the diagnosis and risk stratification in patients with IHD. Assessment of Cardiac FunctionBreath-hold cine MRI with steady-state free precession (SSFP) sequence and segmented k-space acquisition has become the standard method of evaluating the morphology and function of the heart. Right ventricular (RV) function, as well as left ventricular (LV) function and mass, can be accurately determined with cine MRI. 1,2 Compared with cardiac MDCT, excellent delineation of blood and myocardium can be obtained on SSFP cine MRI without contrast administration. 3,4 With the use of cardiac multichannel receiver coils and parallel imaging techniques, such as sensitivity encoding (SENSE), the imaging time of SSFP cine MRI has been considerably shortened. Compared with echocardiography, MRI is not influenced by lung air, allowing the acquisition of high-quality cine MRI of the entire heart in any desired double oblique imaging planes, even in patients with pulmonary emphysema. Cine MRI is less operator-dependent and shows high inter-study reproducibility in the assessment of ventricular volumes and mass. This allows a considerable reduction in the patient numbers required to prove a hypothesis in research studies, offering a potential saving in costs. 5 High-dose dobutamine stress echo (≈40 μg · kg -1 · min -1 ) has become a well-established method for the diagnosis of myocardial ischemia. However, dobutamine stress echo has several disadvantages, including operator dependency and poor endocardial delineation in the basal lateral and inferior segments in a certain percentage of patients. Cine MRI allows noninvasive assessment of altered regional wall motion during dobutamine stress in all segments of the LV, with high spatial and temporal resolution. The respective sensitivity and specificity of high-dose dobutamine stress cine MRI were 83% and 83% by Hundley et al, 6 86% and 86% by Nagel et al, 7 89% and 75% by Jahnke et al, 8 and 78% and 88% by Paetsch et al 9 for the detection of significant CAD. A recent meta-analysis of dobu...

show abstract

Section: Circulation Journal Vol73 September 2009mentioning

confidence: 94%

Cardiac MRI in Ischemic Heart Disease

Ishida

Kato

Sakuma

2009

Circ J

Self Cite

View full text Add to dashboard Cite

show abstract

“…Sensitivities of 81-93% and specificities of 68-90% have been reported for stress first-pass perfusion MRI in the detection of clinically significant coronary artery disease (CAD) as defined at coronary angiography [9][10][11][12][13][14][15][16][17]. However, to the best of out knowledge, there are only three multicenter studies demonstrating the diagnostic performance of firstpass perfusion MRI for the detection of CAD [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of stress myocardial perfusion MRI and late gadolinium-enhanced MRI for detecting flow-limiting coronary artery disease: a multicenter study

et al. 2008

Self Cite

View full text Add to dashboard Cite

The aim of this study was to determine the diagnostic performance of stress and rest perfusion magnetic resonance imaging (MRI) and late gadolinium-enhanced (LGE) MRI for identifying patients with obstructive coronary artery disease (CAD). A total of 50 patients with suspected CAD underwent stress-rest perfusion MRI, followed by LGE MRI with a 1.5-T system. Stress-rest perfusion MRI resulted in an area under the receiveroperating characteristic curve (AUC) of 0.92 for observer 1 and 0.84 for observer 2 with sensitivity and specificity of 89% (32/36) and 79% (11/14) by observer 1, 83% (30/36) and 71% (10/14) by observer 2, respectively, showing a moderate interobserver agreement (Cohen's κ= 0.49). While combination of stressrest perfusion and LGE MRI did not result in improved accuracy for the prediction of flow-limiting obstructive CAD (AUC 0.81 for observer 1 and 0.80 for observer 2), the sensitivity was increased to 92% in both observers with a substantial interobserver agreement (κ=0.70). Stress-rest myocardial perfusion MRI is an accurate diagnostic test for identifying patients with obstructive CAD.

show abstract

“…Recently, Sakuma et al (11,12) used saturation-recovery turbo FLASH sequence for detecting significant stenosis. They reported that in at least one coronary artery the sensitivity was 81.0%, specificity was 68.4%, positive predictive value was 73.9%, negative predictive value was 76.5%, and accuracy of stress perfusion MRI was 75.0%.…”

Section: Discussionmentioning

confidence: 99%

The Usefulness of Stress Perfusion MR using Steady State Free Precession Sequence for Depiction of Significant Coronary Artery Stenosis

Chung

Choi

Kim

et al. 2007

J Korean Radiol Soc

View full text Add to dashboard Cite

Purpose: To evaluate the technical performance of stress myocardial perfusion magnetic resonance (MR) imaging using saturation-recovery steady-state free precession (SR-SSFP) and to assess the diagnostic accuracy of this examination for depiction of significant coronary artery stenosis. Materials and Methods: 167 patients underwent stress myocardial perfusion MR imaging at rest and adenosine-induced stress by using a 1.5-T cardiac MR imaging unit. The first-pass MR perfusion was performed using SR-SSFP sequence. Coronary angiography was performed in 113 patients. Image analysis was performed to compare the diagnostic accuracy of MR imaging with that of coronary angiography. Results: During the MR examination, minor side effects of adenosine-induced stress occurred, most commonly chest discomfort (29%), followed by dyspnea (4%), and facial flushing (0.8%). The overall sensitivity of MR imaging for depicting at least one coronary artery with significant stenosis was 91%. The sensitivities of MR imaging for depiction of stenoses were as follows: 80% for single-vessel stenosis, 81% for doublevessel stenosis, and 100% for triple-vessel stenosis.. The specificity of MR imaging for identification of patients with significant coronary artery stenosis was 78%. Conclusion: Stress myocardial magnetic resonance (MR) perfusion imaging using SR-SSFP sequence is safe and useful for the detection of significant coronary artery disease.

show abstract

Diagnostic Accuracy of Stress First-Pass Contrast-Enhanced Myocardial Perfusion MRI Compared with Stress Myocardial Perfusion Scintigraphy

Cited by 102 publications

References 30 publications

Cardiac MRI in Ischemic Heart Disease

Cardiac MRI in Ischemic Heart Disease

Diagnostic accuracy of stress myocardial perfusion MRI and late gadolinium-enhanced MRI for detecting flow-limiting coronary artery disease: a multicenter study

The Usefulness of Stress Perfusion MR using Steady State Free Precession Sequence for Depiction of Significant Coronary Artery Stenosis

Contact Info

Product

Resources

About