BOLD cardiovascular magnetic resonance at 3.0 tesla in myocardial ischemia

Abstract

BackgroundThe purpose of this study was to determine the ability of Blood Oxygen Level Dependent (BOLD) cardiovascular magnetic resonance (CMR) to detect stress-inducible myocardial ischemic reactions in the presence of angiographically significant coronary artery disease (CAD).MethodsForty-six patients (34 men; age 65 ± 9 years,) with suspected or known coronary artery disease underwent CMR at 3Tesla prior to clinically indicated invasive coronary angiography. BOLD CMR was performed in 3 short axis slices of the heart at rest and during adenosine stress (140 μg/kg/min) followed by late gadolinium enhancement (LGE) imaging. In all 16 standard myocardial segments, T2* values were derived at rest and under adenosine stress. Quantitative coronary angiography served as the standard of reference and defined normal myocardial segments (i.e. all 16 segments in patients without any CAD), ischemic segments (i.e. supplied by a coronary artery with ≥50% luminal narrowing) and non-ischemic segments (i.e. supplied by a non-significantly stenosed coronary artery in patients with significant CAD).ResultsCoronary angiography demonstrated significant CAD in 23 patients. BOLD CMR at rest revealed significantly lower T2* values for ischemic segments (26.7 ± 11.6 ms) compared to normal (31.9 ± 11.9 ms; p < 0.0001) and non-ischemic segments (31.2 ± 12.2 ms; p = 0.0003). Under adenosine stress T2* values increased significantly in normal segments only (37.2 ± 14.7 ms; p < 0.0001).ConclusionsRest and stress BOLD CMR at 3Tesla proved feasible and differentiated between ischemic, non-ischemic, and normal myocardial segments in a clinical patient population. BOLD CMR during vasodilator stress identified patients with significant CAD.

Blood oxygenation level‐dependent (BOLD) MRI of human skeletal muscle at 1.5 and 3 T

“…T2* changes in gradient-echo (GE) echo-planar-imaging (EPI) sequences can mainly be attributed to changes in the intravascular ratio of oxy-to deoxyhemoglobin of the muscle microvasculature (1)(2)(3)(4)(5). Muscle BOLD imaging has been shown to be capable of detecting disturbances of muscle microperfusion in diseases such as peripheral arterial occlusive disease, chronic compartment syndrome, and ischemic heart disease (6)(7)(8)(9).…”

Three-dimensional contrast-enhanced and non-contrast-enhanced cardiac magnetic resonance imaging for the assessment of myocardial ischemic reactions

“…21,46 Investigating myocardial territories being supplied by significantly narrowed 944 Jahnke et al Journal of Nuclear Cardiology 3D contrast-enhanced and non-contrast-enhanced CMR imaging September/October 2011 coronary arteries corresponding T2* values during vasodilator stress remained unchanged or even decreased. Since in these territories, vasodilator reserve was already fully exhausted under resting conditions to maintain myocardial oxygen supply, no further dilatation of the microvascular bed could be provoked under stress conditions.…”

MR Contrast Agents for Cardiac Imaging

“…1 Nonporphyrin necrosis-avid contrast agents (NACAs) at the same intravenous dose of 0.05 mmol/kg induced both T1 and T2 contrast enhancement (CE) with relevant MRI sequences in reperfused MI (arrow) on postmortem images of a dog overnight after injection of bis-Gd-DTPA-pamoic acid derivative (ECIII-60; upper row) and on in vivo images of a pig 6 h after injection of bis-Gd-DTPA-bis-indole derivative (ECIV-7; lower row), suggesting the chemotactic accumulation of NACAs in the necrotic myocardium as proven by the corresponding TTC stained specimen There are also intrinsic MRI contrast substances such as hemoglobin. The paramagnetic property of deoxyhemoglobin to cause local magnetic field distortion and susceptibility has been exploited as the source of blood oxygen level dependent (BOLD) contrast for functional MRI of the brain (Turner 1997), heart (Manka et al 2010) and tumor (Padhani 2010).…”