Multislice MRI in assessment of myocardial perfusion in patients with single-vessel proximal left anterior descending coronary artery disease before and after revascularization

• Published in: Circulation (New York, N.Y.) Vol. 96; no. 9; pp. 2859 - 2867
• Main Authors: LAUERMA, K, VIRTANEN, K. S, SIPILÄ, L. M, HEKALI, P, ARONEN, H. J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 04.11.1997; American Heart Association, Inc
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary Angiography; Coronary Circulation; Coronary Disease - diagnosis; Coronary Disease - physiopathology; Coronary Disease - surgery; Coronary heart disease; Female; Heart; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Myocardial Revascularization; Thallium Radioisotopes; Human; Proximal; Treatment efficiency; Instrumentation therapy; Cardiovascular disease; Instrumental dilatation; Coronary heart disease; Myocardial disease; Nuclear magnetic resonance imaging; Vascular disease; Treatment; Aortocoronary; Ischemia; Bypass; Surgery; Myocardium; Medical imagery; Anterior intraventricular artery
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.9.2859

Our purpose was to use multislice MRI for detection of reversible myocardial ischemia and assessment of the effect of revascularization on tissue perfusion in patients with coronary artery disease. Eleven patients with single-vessel proximal left anterior descending coronary artery disease were studied with MRI and thallium scintigraphy before and 3 months after revascularization. All patients had a reversible perfusion defect by scintigraphy before treatment. With a 1.5-T MR imager, IR-prepared turboflash images were acquired in three left ventricular short-axis planes during 0.05 mmol/kg Gd-DTPA bolus at rest and with dipyridamole-induced stress. Before treatment, stress increased enhancement slope in normal (6.4+/-4.4 to 7.4+/-5.0 s(-1), P<.04) and decreased it in underperfused (5.4+/-3.7 to 2.6+/-1.4 s(-1), P<.02) regions, resulting in a contrast-to-noise ratio of 6.87+/-3.09 in underperfused myocardium. Revascularization normalized enhancement patterns of the formerly underperfused myocardium and decreased defect size both in scintigraphy (66+/-53 degrees to 8+/-12 degrees, P<.001) and MRI sections (49+/-41 degrees to 9+/-8 degrees, P<.001). Agreement of 85% in detection and correlation of 0.86 (SEE, 21 degrees, P<.001) in sizing perfusion defects was found between MRI and scintigraphy. Multislice contrast-enhanced MRI can be used to detect myocardial perfusion defects in patients with coronary artery disease and in assessment of the effect of treatment on myocardial perfusion.