Efficacy of Oral Dipyridamole Cinemagnetic Resonance Imaging in Detecting Coronary Artery Disease - Initial Experience

Abstract

Exercise or dipyridamole (DP) thallium-201 perfusion imaging is a widely accepted stress technique for the early detection of coronary artery disease. An alternative to perfusion imaging is the assessment of regional left ventricular function, which is felt to reflect the earliest signs of subendocardial and transmurai ischemia. We examined 13 patients with angiographically documented coronary artery disease (≥70% diameter stenosis) using cine-magnetic resonance imaging (C-MRI) before and after DP administration. Angiographic findings of the 3 major coronary arteries were compared with segmental wall motion and systolic wall thickening of the related left ventricular myocardial segments. The 39 left ventricular segments evaluated in these 13 patients demonstrated a 95% sensitivity (p < 0.01) and a 100% specificity (p > 0.05) when post-DP C-MRI results were assessed. In 4 patients, it was not possible to assess systolic wall thickening because of motion artifacts, but wall motion analysis with the cine-loop display was still possible. There was a trend toward superiority utilizing the qualitative cine-method rather than that of quantitative systolic wall tickening. DP C-MRI appears to be a promising method for the evaluation of left ventricular cardiac function.