Detection of Regional Myocardial Perfusion Deficit Using Rest and Stress Perfusion MRI: A Feasibility Study

• Published in: American journal of roentgenology (1976) Vol. 185; no. 3; pp. 627 - 635
• Main Authors: Fenchel, Michael, Helber, Uwe, Kramer, Ulrich, Stauder, Norbert I, Franow, Andreas, Claussen, Claus D, Miller, Stephan
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.09.2005; American Roentgen Ray Society
• Subjects: Adult; Aged; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Contrast Media; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary Circulation; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Feasibility Studies; Female; Gadolinium DTPA; Heart; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Radionuclide Imaging; Sensitivity and Specificity; Radionuclide study; Heart; Single coronary artery; Infarct; Cardiovascular disease; Single photon emission tomography; Congenital disease; Coronary heart disease; Nuclear magnetic resonance imaging; Stress; Arterial disease; Vascular disease; Rest; FISP sequence; Ischemia; Malformation; Perfusion; Blood vessel; Myocardium; Medical imagery; Feasibility; Multislice; Positron emission tomography; Signal to noise ratio
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.185.3.01850627

Providing high temporal and spatial resolution, perfusion MRI is an attractive alternative to traditional radionuclide methods like SPECT and PET. Although first-pass perfusion MRI examinations have gained increasing attention during the past years, this technique still exhibits relatively low signal-to-noise ratio and cardiac coverage. Previous studies have suggested that refocused gradient sequence technology (e.g., true fast imaging with steady-state precession [FISP]) should improve perfusion MRI examinations. The aim of this study was to assess myocardial perfusion deficits in patients with proven coronary artery disease using a saturation recovery true FISP perfusion sequence. Rest and stress perfusion MRI studies were performed in 22 patients with coronary artery disease at 1.5 T using a multislice saturation recovery true FISP sequence after the bolus injection of 0.025 mmol/kg of body weight of gadopentetate dimeglumine. The myocardium of each slice was divided into 12 radial segments with subdivision into subendocardial and subepicardial subregions. Myocardial perfusion was assessed semiquantitatively and independently for each subregion. The standard of reference for myocardial perfusion was SPECT. Delayed enhancement images were acquired after the injection of 0.15 mmol/kg of body weight of gadopentetate dimeglumine. Sensitivity and specificity of perfusion MRI examinations for the detection of perfusion deficits were 81% and 89%, respectively, for the semiquantitative perfusion parameter upslope and 78% and 86% for the parameter peak signal intensity. More specifically, rest perfusion examinations were able to detect areas of infarction, whereas stress examinations increased the perfusion differences between normal and ischemic myocardial areas. Excellent correlation was observed between rest perfusion and late enhancement findings (r = 0.90). In patients with single-vessel coronary artery disease, perfusion deficits can reliably be detected using a saturation recovery true FISP sequence. Semiquantitative perfusion parameters upslope and peak signal intensity yielded similar results.