Diagnostic Accuracy of Myocardial Magnetic Resonance Perfusion to Diagnose Ischemic Stenosis With Fractional Flow Reserve as Reference

Li, Min; Zhou, Tao; Yang, Linfeng; Peng, Zhongmin; Ding, Juan; Sun, Gang

doi:10.1016/j.jcmg.2014.07.011

Cited by 77 publications

(55 citation statements)

References 52 publications

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“…A number of recent studies of perfusion CMR have used invasive FFR as a reference standard with good results. [9, 30] A meta-analysis by Jiang et al reports a sensitivity and specificity of 88% each when FFR is used as a reference standard. Future studies of the rapid ungated approach could possibly be better validated using FFR as the reference standard in all patients, even in patients without stenoses that appear significant by visual assessment.…”

Section: Discussionmentioning

confidence: 99%

Rapid rest/stress regadenoson ungated perfusion CMR for detection of coronary artery disease in patients with atrial fibrillation

Bieging

Haider

Adluru

et al. 2017

Int J Cardiovasc Imaging

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Purpose Cardiovascular magnetic resonance (CMR) perfusion has been established as a useful imaging modality for the detection of coronary artery disease (CAD). However, there are several limitations when applying standard, ECG-gated stress/rest perfusion CMR to patients with atrial fibrillation (AF). In this study we investigate an approach with no ECG gating and a rapid rest/stress perfusion protocol to determine its accuracy for detection of CAD in patients with AF. Methods 26 patients with AF underwent a rapid rest/regadenoson stress CMR perfusion imaging protocol, and all patients had X-ray coronary angiography. An ungated radial myocardial perfusion sequence was used. Imaging protocol included: rest perfusion image acquisition, followed nearly immediately by administration of regadenoson to induce hyperemia, 60 second wait, and stress image acquisition. CMR perfusion images were interpreted by three blinded readers as normal or abnormal. Diagnostic accuracy was evaluated by comparison to X-ray angiography. Results 21 of the CMR rest/stress perfusion scans were negative, and 5 were positive by angiography criteria. Majority results of the ungated datasets from all of the readers showed a sensitivity, specificity and accuracy of 80%, 100% and 96%, respectively, for detection of CAD. Conclusions An ungated, rapid rest/stress regadenoson perfusion CMR protocol appears to be useful for the diagnosis of obstructive CAD in patients with AF.

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Section: Discussionmentioning

confidence: 99%

Rapid rest/stress regadenoson ungated perfusion CMR for detection of coronary artery disease in patients with atrial fibrillation

Bieging

Haider

Adluru

et al. 2017

Int J Cardiovasc Imaging

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show abstract

“…Thus, stress perfusion CMR can detect functionally significant CAD with excellent diagnostic accuracy. In a meta-analysis reported by Li et al [12], perfusion CMR allowed for the accurate detection of ischemic CAD with FFR as the reference standard. The pooled sensitivity, specificity, and AUC were 0.90, 0.87, and 0.95 at the patient level and 0.89, 0.86, and 0.93 at the vessel level, respectively.…”

Section: Cviamentioning

confidence: 99%

“…Stress perfusion CMR offers several advantages over SPECT, including a high spatial resolution and no radiation exposure. Stress perfusion CMR yields high diagnostic accuracy for the detection of CAD [3][4][5][6][7][8][9][10][11][12][13], and its prognostic value has also been documented [14,15].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Myocardial Ischemia Using Stress Perfusion Cardiovascular Magnetic Resonance

Yamada

Ishida

Kitagawa

et al. 2018

Cardiovasc Imaging Asia

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Coronary artery disease (CAD) is a major cause of mortality and morbidity throughout the world, and its prevalence is expected to increase worldwide. Myocardial ischemia is a strong predictor of future adverse outcomes in patients with suspected CAD. The detection of ischemia is an important part of the diagnostic strategy for patients with suspected CAD. Stress myocardial perfusion cardiovascular magnetic resonance (CMR) is a noninvasive diagnostic approach for the detection of myocardial ischemia. CMR offers several advantages over single-photon emission computed tomography, such as high spatial resolution and no radiation exposure. Stress perfusion CMR offers high diagnostic performance for the detection of CAD and prognostic value in patients with suspected CAD. In this review, we describe how to perform stress perfusion CMR and interpret its findings. We also discuss recent updates concerning the diagnostic and prognostic value of stress perfusion CMR in patients with suspected CAD.

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“…Li et al showed that with FFR as the reference standard, the pooled sensitivity and specificity of stress perfusion CMR were 90% and 87%, respectively 10. They also demonstrated that CMR could increase the post-test probability of CAD to over 80% in patients with a pretest probability (PTP) of >37% and could decrease post-test probability of CAD to <20% with a PTP of <72%.…”

Section: Ischaemia Detectionmentioning

confidence: 99%

Role of cardiovascular magnetic resonance in the management of patients with stable coronary artery disease

Motwani

Swoboda

Plein

et al. 2017

Heart

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Cardiovascular magnetic resonance (CMR) assesses cardiac function, ischaemia, viability and tissue characterisation, all within a single scan. Many studies regarding the role of CMR in stable coronary artery disease (CAD) have been published over the last decade providing important technical advances, large-scale clinical validation and prognostic data. As a result, CMR has emerged as a highly accurate technique for diagnosis and risk stratification in stable CAD and has been incorporated into national and international guidelines. Furthermore, clinical pathways utilising CMR have been shown to be the most cost-effective in several healthcare systems. In this review, we summarise the key roles and guideline recommendations for CMR in stable CAD supported by contemporary clinical evidence.

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Diagnostic Accuracy of Myocardial Magnetic Resonance Perfusion to Diagnose Ischemic Stenosis With Fractional Flow Reserve as Reference

Abstract: With FFR as the reference standard, the diagnostic ability of MR perfusion to detect ischemic CAD is high.

Cited by 77 publications

References 52 publications

Rapid rest/stress regadenoson ungated perfusion CMR for detection of coronary artery disease in patients with atrial fibrillation

Rapid rest/stress regadenoson ungated perfusion CMR for detection of coronary artery disease in patients with atrial fibrillation

Assessment of Myocardial Ischemia Using Stress Perfusion Cardiovascular Magnetic Resonance

Role of cardiovascular magnetic resonance in the management of patients with stable coronary artery disease

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