Magnetic Resonance Perfusion Measurements for the Noninvasive Detection of Coronary Artery Disease

Abstract

Background-With MRI, an index of myocardial perfusion reserve (MPRI) can be determined. We assessed the value of this technique for the noninvasive detection of coronary artery disease (CAD) in patients with suspected CAD. Methods and Results-Eighty-four patients referred for a primary diagnostic coronary angiography were examined with a 1.5 T MRI tomograph (Philips-ACS). For each heartbeat, 5 slices were acquired during the first pass of 0.025 mmol gadolinium-diethylenetriamine pentaacetic acid/kg body weight before and during adenosine vasodilation by using a turbo-gradient echo/echo-planar imaging-hybrid sequence. MPRI was determined from the alteration of the upslope of the myocardial signal intensity curves for 6 equiangular segments per slice. Receiver operating characteristics were performed for different criteria to differentiate ischemic and nonischemic segments. Prevalence of CAD was 51%. Best results were achieved when only the 3 inner slices were assessed and a threshold value of 1.1 was used for the second smallest value as a marker for significant CAD. This approach yielded a sensitivity of 88%, specificity of 90%, and accuracy of 89%. Conclusion-The determination of MPRI with MRI yields a high diagnostic accuracy in patients with suspected CAD.(Circulation. 2003;108:432-437.)

PET imaging of cardiac hypoxia: Opportunities and challenges

“…Even though these data show a correlation between degree of ischemia and outcome [7], and provide a threshold for the appropriateness of revascularization, it is impossible to determine the clinical significance of reduced blood flow for an individual patient [8]. While generating fully quantitative data (i.e.…”

Frontiers in Cardiovascular Magnetic Resonance

“…There are convincing data that correlate MR indexes of perfusion with tissue perfusion in animal models 60,61 and excellent correlations with radionuclide imaging and invasive x-ray angiography in humans. [62][63][64] However, the published data so far do not demonstrate the feasibility of stress perfusion MR for everyday clinical use. The current studies are limited in that they were either retrospective (for patient enrollment and data analysis), required central venous catheters, imaged only 1 to 2 slices per heartbeat, or excluded patients with diabetes.…”

The Prognostic Value of Normal Stress Cardiovascular Magnetic Resonance Imaging

“…Recent advances in cardiac magnetic resonance imaging (cardiac MRI: CMR) have enabled dynamic first-pass contrast-enhanced imaging of the entire left-ventricular myocardium and cardiac wall motion imaging with improved image quality. Against this background, reports on the evaluation of coronary artery disease (CAD) and prognosis of patients suspected of having CAD by CMR have been increasing [1][2][3][4]. Recently, several prognostic studies with various follow-up periods using CMR have been reported [5][6][7][8].…”