Magnetic resonance imaging of regional myocardial perfusion in patients with single-vessel coronary artery disease: Quantitative comparison with201Thallium-SPECT and coronary angiography

Keijer, J.; Rossum, Albert C. van; Eenige, M. J. van; Bax, Jeroen J.; Visser, Frans C.; Teule, Jaap J.; Visser, Cees A.

doi:10.1002/1522-2586(200006)11:6<607::aid-jmri6>3.0.co;2-7

Cited by 73 publications

(35 citation statements)

References 46 publications

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“…Our results were also excellent compared with prior studies using MRMPI and suggest that the value of MRMPI may have been underestimated. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Two previous studies have compared MRMPI with FFR. In the first study, however, patient numbers were small (nϭ43), and FFR was measured in only 33% of arteries.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have compared it with more established techniques such as single-photon emission computerized tomography (SPECT), [1][2][3] positron emission tomography, 4,5 and invasive coronary angiography (CA). 1,[3][4][5][6][7][8][9][10][11][12][13][14][15] It has a number of advantages over the other noninvasive techniques, including high spatial and temporal resolution, no exposure to ionizing radiation, no attenuation or scatter artifacts, and no image orientation constraints.…”

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confidence: 99%

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Validation of Magnetic Resonance Myocardial Perfusion Imaging With Fractional Flow Reserve for the Detection of Significant Coronary Heart Disease

et al. 2009

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Background-Magnetic resonance myocardial perfusion imaging (MRMPI) has a number of advantages over the other noninvasive tests used to detect reversible myocardial ischemia. The majority of previous studies have generally used quantitative coronary angiography as the gold standard to assess the accuracy of MRMPI; however, only an approximate relationship exists between stenosis severity and functional significance. Pressure wire-derived fractional flow reserve (FFR) values Ͻ0.75 correlate closely with objective evidence of reversible ischemia. Accordingly, we have compared MRMPI with FFR. Methods and Results-One hundred three patients referred for investigation of suspected angina underwent MRMPI with a 1.5-T scanner. The stress agent was intravenous adenosine (140 g · kg Ϫ1 · min Ϫ1 ), and the first-pass bolus contained 0.1 mmol/kg gadolinium. In the following week, coronary angiography with pressure wire studies was performed. FFR was recorded in all patent major epicardial coronary arteries, with a value Ͻ0.75 denoting significant stenosis. MRMPI scans, analyzed by 2 blinded observers, identified perfusion defects in 121 of 300 coronary artery segments (40%), of which 110 had an FFR Ͻ0.75. We also found that 168 of 179 normally perfused segments had an FFR Ն0.75. The sensitivity and specificity of MRMPI for the detection of functionally significant coronary heart disease were 91% and 94%, respectively, with positive and negative predictive values of 91% and 94%. Conclusion-MRMPI can detect functionally significant coronary heart disease with excellent sensitivity, specificity, and positive and negative predictive values compared with FFR. (Circulation. 2009;120:2207-2213.)

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Validation of Magnetic Resonance Myocardial Perfusion Imaging With Fractional Flow Reserve for the Detection of Significant Coronary Heart Disease

et al. 2009

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“…However, some studies reported only poor correlation. This might be due to low patient numbers and attenuation artifacts in PET/SPECT, especially at the posterior myocardial wall (4,24). The same problem may be of relevance in our study where we found moderate correlation of MRI perfusion data with SPECT (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Multislice first‐pass myocardial perfusion imaging: Comparison of saturation recovery (SR)‐TrueFISP‐two‐dimensional (2D) and SR‐TurboFLASH‐2D pulse sequences

Fenchel

Helber

Simonetti

et al. 2004

Magnetic Resonance Imaging

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Purpose:To compare signal-to-noise ratio (SNR), contrastto-noise (CNR) ratio, and diagnostic accuracy of a newly developed saturation recovery (SR)-TrueFISP-two-dimensional (2D) sequence with an SR-TurboFLASH-2D sequence. Materials and Methods:In seven healthy subjects and nine patients with coronary artery disease (CAD), contrastenhanced perfusion imaging (with Gd-DTPA) was performed with SR-TrueFISP and SR-TurboFLASH sequences. Hypoperfused areas were assessed qualitatively (scale ϭ 0 -4). Furthermore, SNR and CNR were calculated and semiquantitative perfusion parameters were determined from signal intensity (SI) time curves. Standard of reference for patient studies was single-photon emission computer tomography (SPECT) and angiography. Results:The perception of perfusion deficits was superior in TrueFISP images (2.6 Ϯ 1.0) than in TurboFLASH (1.4 Ϯ 0.6) (P Ͻ 0.001). Phantom measurements yielded increased SNR (143 Ϯ 34%) and CNR (158 Ϯ 64%) values for True-FISP. In patient/volunteer studies SNR was 61% to 100% higher and signal enhancement was 110% to 115% higher with TrueFISP than with TurboFLASH. Qualitative and semiquantitative assessment of perfusion defects yielded higher sensitivities for detection of perfusion defects with TrueFISP (68% to 78%) than with TurboFLASH (44% to 59%). Conclusion:SR-TrueFISP-2D perfusion imaging provides superior SNR and CNR than TurboFLASH imaging. Moreover, the dynamic range of SIs was found to be higher with TrueFISP, resulting in an increased sensitivity for detection of perfusion defects.

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“…Previous reports revealed that MRI perfusion images are as good as conventional nuclear perfusion images. [36][37][38][39] As a result, we speculate that our results are also closely correlated with conventional nuclear perfusion imagings. Lastly, we did not evaluate the effect of coronary revascularization on MRI perfusion images.…”

Section: Discussionmentioning

confidence: 99%

Whole-Heart Dipyridamole Stress First-Pass Myocardial Perfusion MRI for the Detection of Coronary Artery Disease

et al. 2004

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SUMMARYA whole-heart coverage MRI sequence, which employes a hybrid of fast gradient echo and echo planar acquisition imaging (FastCard EchoTrain), has recently been developed. Using this sequence, a first-pass myocardial perfusion MRI was shown to be a good noninvasive modality for detecting coronary artery disease (CAD) in a clinical setting. In addition, the clinical usefulness of delayed enhanced MRI has recently been reported. The objectives of this study were (1) to investigate the accuracy of dipyridamole stress firstpass myocardial perfusion MRI for diagnosing CAD (> 50% stenosis) and (2) to clarify whether additional delayed enhancement MRI has any clinical significance. We performed first-pass myocardial perfusion MRI in 102 consecutive patients (66 ± 9 years old) suspected to have CAD or new lesions in patients with well-documented prior myocardial infarction (MI). Using a 1.5 T cardiac MR imager (GE CV/i), eight short axis MR images of the left ventricle were acquired by injecting gadolinium (0.1 mmol/kg) under dipyridamole infusion stress (0.56 mg/kg). Fifteen minutes later, aminophylline (250 mg) was injected and first-pass perfusion MRI was repeated in the resting state in order to evaluate both the presence of perfusion defect and delayed enhancement. The presence of perfusion defect and delayed enhancement was determined based on a visual qualitative analysis by the agreement of two separate readers who were blinded to any clinical information. Based on the stress and rest findings, no defect, reversible defect, or fixed defect with or without delayed enhancement was recorded in any patient. The MR findings revealed 76 CAD patients, including 24 MI patients with new lesions and 26 patients without CAD on coronary angiography. The presence of stress perfusion defect had a 93% sensitivity and an 85% specificity for diagnosing CAD. A fixed defect showed an 86% sensitivity and a 66% specificity for diagnosing a prior MI. Patients with a fixed defect with delayed enhancement had more significant stenosis in the infarct related artery than in those without any enhancement (11/26 vs 15/20, P < 0.05).

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Magnetic resonance imaging of regional myocardial perfusion in patients with single-vessel coronary artery disease: Quantitative comparison with201Thallium-SPECT and coronary angiography

Cited by 73 publications

References 46 publications

Validation of Magnetic Resonance Myocardial Perfusion Imaging With Fractional Flow Reserve for the Detection of Significant Coronary Heart Disease

Validation of Magnetic Resonance Myocardial Perfusion Imaging With Fractional Flow Reserve for the Detection of Significant Coronary Heart Disease

Multislice first‐pass myocardial perfusion imaging: Comparison of saturation recovery (SR)‐TrueFISP‐two‐dimensional (2D) and SR‐TurboFLASH‐2D pulse sequences

Whole-Heart Dipyridamole Stress First-Pass Myocardial Perfusion MRI for the Detection of Coronary Artery Disease

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