Blood oxygen level-dependent magnetic resonance imaging using T2-prepared steady-state free-precession imaging in comparison to contrast-enhanced myocardial perfusion imaging

• Published in: International journal of cardiology Vol. 147; no. 3; pp. 416 - 419
• Main Authors: Bernhardt, Peter, Manzke, Robert, Bornstedt, Axel, Gradinger, Robert, Spieß, Jochen, Walcher, Daniel, Rasche, Volker, Hombach, Vinzenz
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 17.03.2011; Elsevier
• Subjects: Adenosine-stress; Aged; Biological and medical sciences; BOLD; Cardiac magnetic resonance imaging; Cardiology. Vascular system; Cardiovascular; Coronary Vessels - diagnostic imaging; Coronary Vessels - metabolism; Female; Humans; Magnetic Resonance Imaging, Cine - methods; Male; Medical sciences; Middle Aged; Myocardial Ischemia - diagnosis; Myocardial Ischemia - diagnostic imaging; Myocardial Ischemia - metabolism; Myocardial Perfusion Imaging - methods; Myocardium - metabolism; Oxygen - blood; Perfusion; BOLD; Adenosine-stress; Perfusion; Cardiac magnetic resonance imaging; Heart; Adenosine; Oxygen; Exploration; Cardiovascular disease; Concentration; Nuclear magnetic resonance imaging; Steady state; Blood; Stress; Perfusion imaging; Myocardium; Medical imagery; Cardiology; Comparative study; Contrast media
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2009.09.547

Abstract Background Diagnosis of inducible myocardial ischemia is important for deciding further diagnosis and therapy in coronary artery disease (CAD). Blood oxygen level-dependent (BOLD) cardiac magnetic resonance imaging (CMR) is a potential method to evaluate myocardial perfusion reserve alternatively to first-pass perfusion using contrast agents. Methods and results We imaged 46 patients with suspected CAD on a 1.5 T whole-body CMR scanner using a T2-prepared steady-state free-precession (SSFP) BOLD-sensitive sequence and a SSFP-based first-pass sequence. All patients were scanned during rest and after 3 min of adenosine infusion (140 µg/kg/min). For myocardial first-pass visualization 0.1 mmol/kg Gadolinium-based contrast agent was used. In 90 myocardial segments a first-pass perfusion deficit could be seen. Relative BOLD signal increase was significantly lower in patients with perfusion deficits compared to patients without perfusion deficits ( p < 0.0001). Patients with non-transmural and with transmural first-pass perfusion deficit also differed significantly for BOLD signal increase ( p < 0.0001). ROC analysis showed an area under the curve of 0.83 for the T2-prepared SSFP sequence regarding detection of inducible perfusion deficit. Conclusions T2-prepared BOLD imaging allows for visualization of myocardial perfusion reserve in a clinical setting without additional use of contrast agents.