Feasibility of high-dose dipyridamole-magnetic resonance imaging for detection of coronary artery disease and comparison with coronary angiography

Baer, Frank M.; Smolarz, Kamilla; Jungehülsing, M.; Theissen, P.; Sechtem, Udo; Schicha, H.; Hilger, H. H.

doi:10.1016/0002-9149(92)90675-o

Cited by 66 publications

(20 citation statements)

References 25 publications

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“…Again, this hypothesis needs fur ther investigation. It has been suggested that the systolic wall thickening method for the evaluation of regional wall function may be more accurate than the cine-loop display wall motion analysis method [12,18]. Although there was not a statistically demonstrably significance, we found the sensitivity and specificity of the systolic wall thickening method to be slightly lower than in the wall motion analy sis method.…”

Section: Discussioncontrasting

confidence: 68%

“…Lately, DP with cardiac MRI has been investigated for the detection of coronary artery disease [14,15,18,[22][23][24], Baer et al [18] have reported the overall sensitivity of DP C-MRI for the detection of coronary artery disease to be 78%. They found the sensitivity/specificity of DP C-MRI for localization of the disease to range from 73/87 to 100/100% for the 3 main coronary artery territories.…”

Section: Resultsmentioning

confidence: 99%

“…The safety of intravenously administered DP for car diac MR examination has been established [18]. Although the intravenous route has been preferred for radionuclide evaluation because of indeterminate absorption rate with oral administration, we felt that oral DP offered signifi cant advantages as to onset and duration of action for the purpose of MRI acquisition.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Oral Dipyridamole Cinemagnetic Resonance Imaging in Detecting Coronary Artery Disease - Initial Experience

Zegel¹,

Tuncalı²,

Beers³

et al. 1993

Am J Noninvas Cardiol

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Exercise or dipyridamole (DP) thallium-201 perfusion imaging is a widely accepted stress technique for the early detection of coronary artery disease. An alternative to perfusion imaging is the assessment of regional left ventricular function, which is felt to reflect the earliest signs of subendocardial and transmurai ischemia. We examined 13 patients with angiographically documented coronary artery disease (≥70% diameter stenosis) using cine-magnetic resonance imaging (C-MRI) before and after DP administration. Angiographic findings of the 3 major coronary arteries were compared with segmental wall motion and systolic wall thickening of the related left ventricular myocardial segments. The 39 left ventricular segments evaluated in these 13 patients demonstrated a 95% sensitivity (p < 0.01) and a 100% specificity (p > 0.05) when post-DP C-MRI results were assessed. In 4 patients, it was not possible to assess systolic wall thickening because of motion artifacts, but wall motion analysis with the cine-loop display was still possible. There was a trend toward superiority utilizing the qualitative cine-method rather than that of quantitative systolic wall tickening. DP C-MRI appears to be a promising method for the evaluation of left ventricular cardiac function.

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Section: Discussioncontrasting

confidence: 68%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efficacy of Oral Dipyridamole Cinemagnetic Resonance Imaging in Detecting Coronary Artery Disease - Initial Experience

Zegel¹,

Tuncalı²,

Beers³

et al. 1993

Am J Noninvas Cardiol

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“…The sensitivity for the detection of angiographically significant coronary artery disease was 62%. Baer et al [2] studied a more homogeneous group of 23 patients without resting wall motion abnormalities. A dose of 0.75 mg/kg was used and the overall detection rate of coronary artery disease was 78% compared to coronary angiography.…”

Section: Comparison Of Dipyridamole Mri and Dipyridamole-stress Echocmentioning

confidence: 99%

Magnetic Resonance Pharmacological Stress for Detecting Coronary Disease

Baer

Crnac

Schmidt

et al. 2000

Herz

Self Cite

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Stress testing is the cornerstone in the diagnosis of patients with suspected coronary artery disease (CAD). Although exercise ECG remains the primary approach for the detection of ischemia in patients with chest pain syndromes, its sensitivity and specificity is limited and exercise ECG does not provide detailed information about the localisation and extent of CAD. Stress echocardiography has been used for the detection of ischemia for more than a decade and has become an increasingly popular noninvasive method for the detection of CAD. In experienced hands wall motion analysis based on stress echocardiography has proved to be as sensitive and specific for the detection of myocardial ischemia as scintigraphic techniques. Recent technical improvements, namely the availability of ultrafast imaging sequences with a significant reduction of imaging time have initiated several studies which examined the combination of pharmacological stress and magnetic resonance imaging (MRI) for the detection of suspected CAD. The most well developed stress-MRI technique is wall motion imaging during dobutamine stress. This technique is analogous to stress echocardiography, but MRI has the inherent advantages of better resolution, higher reproducibility and true long and short axis imaging with contiguous parallel slices. However, the clinical impact of MRI for the diagnosis of CAD is still low. Further technical developments including real time imaging and a reliable automated quantitative analysis of left ventricular function are required before stress-MRI becomes a serious challenge to stress-echocardiography in the clinical arena. Currently, only a few MRI facilities and physicians are dedicated to pharmacological stress testing with MRI and the future clinical impact of this promising technique will depend on its potential to provide information beyond myocardial function including perfusion, metabolism and coronary anatomy in form of a "one-stop"-shop for the cardiac patient.

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“…The gradient echo (cine) MR imaging technique has been used to evaluate global and regional LV function. However, most studies relied on visual assessment of wall motion and wall thickening (12, [14][15][16], which precludes measurement of large numbers of data points and suffers from observer bias. To date, the number of measurements used for regional LV wall function analysis is limited by the lack of sophisticated analysis software.…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of regional left ventricular function after myocardial infarction in the pig assessed with cine magnetic resonance imaging

Holman

Vliegen

Geest

et al. 1995

Magnetic Resonance in Med

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To assess the accuracy of quantitative analysis of global and regional wall motion and wall thickening of the left ventricle with cine magnetic resonance (MR), images obtained in eight pigs before and after myocardial infarction were compared with those obtained using gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced multislice spin-echo MR imaging and determination of pathology. The region with abnormal wall motion and wall thickening, as determined with cine MR imaging, identified the same region of infarction as indicated by Gd-DTPA-enhanced spin-echo MR imaging and pathology. Within the infarcted region wall motion and wall thickening analyzed with the centerline method were significantly reduced. We conclude that the use of quantitative analysis of cine MR images accurately determines localization and extent of regional left ventricular dysfunction in the infarcted heart in vivo. This analysis using dedicated software including the centerline method allows sequential assessment of regional left ventricular function in normal and infarcted hearts.

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Feasibility of high-dose dipyridamole-magnetic resonance imaging for detection of coronary artery disease and comparison with coronary angiography

Cited by 66 publications

References 25 publications

Efficacy of Oral Dipyridamole Cinemagnetic Resonance Imaging in Detecting Coronary Artery Disease - Initial Experience

Efficacy of Oral Dipyridamole Cinemagnetic Resonance Imaging in Detecting Coronary Artery Disease - Initial Experience

Magnetic Resonance Pharmacological Stress for Detecting Coronary Disease

Quantitative analysis of regional left ventricular function after myocardial infarction in the pig assessed with cine magnetic resonance imaging

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