Quantification of myocardial blood flow using model based analysis of first‐pass perfusion MRI: Extraction fraction of Gd‐DTPA varies with myocardial blood flow in human myocardium

Abstract

For the absolute quantification of myocardial blood flow (MBF), Patlak plot-derived K1 need to be converted to MBF by using the relation between the extraction fraction of gadolinium contrast agent and MBF. This study was conducted to determine the relation between extraction fraction of Gd-DTPA and MBF in human heart at rest and during stress. Thirty-four patients (19 men, mean age of 66.5 6 11.0 years) with normal coronary arteries and no myocardial infarction were retrospectively evaluated. First-pass myocardial perfusion MRI during adenosine triphosphate stress and at rest was performed using a dual bolus approach to correct for saturation of the blood signal. Myocardial K1 was quantified by Patlak plot method. Mean MBF was determined from coronary sinus flow measured by phase contrast cine MRI and left ventricle mass measured by cine MRI. The extraction fraction of Gd-DTPA was calculated as the K1 divided by the mean MBF. The extraction fraction of Gd-DTPA was 0.46 6 0.22 at rest and 0.32 6 0.13 during stress (P < 0.001). The relationship between extraction fraction (E) and MBF in human myocardium can be approximated as E 5 1 2 exp(2(0.14 3 MBF 1 0.56)/MBF). The current results indicate that MBF can be accurately quantified by Patlak plot method of first-pass myocardial perfusion MRI by performing a correction of extraction fraction. Magn Reson Med 66:1391-1399,

Impaired Myocardial Perfusion Reserve in Patients With Fatty Liver Disease Assessed by Quantitative Myocardial Perfusion Magnetic Resonance Imaging

“…After calculating the perfusion parameter K1 in the 16 myocardial segments, MBF was calculated as K1 divided by the extraction fraction of Gd-DTPA, using extraction fraction values from a previous study. 21 MPR was determined as stress MBF divided by rest MBF.…”

Comparison of the Diagnostic Performance of Four Quantitative Myocardial Perfusion Estimation Methods Used in Cardiac MR Imaging: CE-MARC Substudy

“…The one-compartment model (16,17,27) assumes that the myocardium is flow limited, meaning that the permeability between the vascular and extracellular spaces is sufficiently high and that the two spaces act as one compartment. The uptake model (12,(18)(19)(20) makes the further assumption that at early time points, venous output concentration is zero, reducing the analysis to a straight line fit.…”

“…Given the null hypothesis that no difference exists between the MBF estimates generated with different methods, the purpose of this study was to compare the diagnostic performance of four tracer kinetic analysis methods in the quantification of myocardial perfusion from MR imaging cardiac perfusion data sets in terms of their ability to aid in the diagnosis of myocardial ischemia. The selected models were chosen to represent the most commonly used methods appropriate for use in the heart; thus, we used Fermi-constrained deconvolution (6,8,9,13), model-independent deconvolution (14,15), a onecompartment model (16,17), and an uptake model (12,(18)(19)(20).…”

Hypertrophic cardiomyopathy: Cardiac structural and microvascular abnormalities as evaluated with multi-parametric MRI

“…Of these techniques, first-pass dynamic contrast-enhanced (DCE)-MRI allows to noninvasively quantitate myocardial perfusion (F) in varies of heart diseases by using model-free or compartmental model-dependent analysis [17][18][19]. Despite this, comparatively little work has been published on the measurement of myocardial microvascular characteristics relevant to myocardial permeabilitysurface area product (PS) and interstitial volume (V e ) with the established DCE imaging technique.…”