MRI detection of myocardial perfusion changes by gadolinium‐DTPA infusion during dipyridamole hyperemia

Miller, D. Douglas; Holmvang, Godtfred; Gill, John B.; Dragotakes, Donna; Kantor, Howard L.; Okada, Robert D.; Brady, Thomas J.

doi:10.1002/mrm.1910100209

Cited by 71 publications

(28 citation statements)

References 13 publications

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“…In myocarditis, T2-weighted imaging may detect tissue edema, which is usually absent in ARVC [104]. In addition, fast spin-echo T1-weighted images during the first minutes after contrast injection may be useful to detect myocardial hyperemia and muscular inflammation suggestive of myocarditis [104],[105]. In equivocal cases, invasive studies such as electroanatomic mapping and endomyocardial biopsy may provide a more definite diagnosis [63].…”

Section: Update On Arvc Geneticsmentioning

confidence: 99%

Arrhythmogenic right ventricular cardiomyopathy (ARVC): cardiovascular magnetic resonance update

Riele

Tandri

Bluemke

2014

Journal of Cardiovascular Magnetic Resonance

146

133

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Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) is one of the most arrhythmogenic forms of inherited cardiomyopathy and a frequent cause of sudden death in the young. Affected individuals typically present between the second and fourth decade of life with arrhythmias coming from the right ventricle. Pathogenic mutations in genes encoding the cardiac desmosome can be found in approximately 60% of index patients, leading to our current perception of ARVC as a desmosomal disease. Although ARVC is known to preferentially affect the right ventricle, early and/or predominant left ventricular involvement is increasingly recognized. Diagnosis is made by combining multiple sources of diagnostic information as prescribed by the “Task Force” criteria. Recent research suggests that electrical abnormalities precede structural changes in ARVC. Cardiovascular Magnetic Resonance (CMR) is an ideal technique in ARVC workup, as it provides comprehensive information on cardiac morphology, function, and tissue characterization in a single investigation. Prevention of sudden cardiac death using implantable cardioverter-defibrillators is the most important management consideration. This purpose of this paper is to provide an updated review of our understanding of the genetics, diagnosis, current state-of-the-art CMR acquisition and analysis, and management of patients with ARVC.

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Section: Update On Arvc Geneticsmentioning

confidence: 99%

Arrhythmogenic right ventricular cardiomyopathy (ARVC): cardiovascular magnetic resonance update

Riele

Tandri

Bluemke

2014

Journal of Cardiovascular Magnetic Resonance

146

133

View full text Add to dashboard Cite

show abstract

“…6 -12 Parameters for the assessment of myocardial perfusion are usually gained by analyzing the first pass of a contrast agent bolus through the myocardium. 6,9,13,14 With extensive modeling, quantitative determination of myocardial perfusion is possible; however, this approach relies on several assumptions that may not be fulfilled in patients. 13,[15][16][17] We have recently shown that a linear fit of the upslope is easy to perform, is highly reproducible, and shows promising accuracy in a selected patient population.…”

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confidence: 99%

Magnetic Resonance Perfusion Measurements for the Noninvasive Detection of Coronary Artery Disease

et al. 2003

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Background-With MRI, an index of myocardial perfusion reserve (MPRI) can be determined. We assessed the value of this technique for the noninvasive detection of coronary artery disease (CAD) in patients with suspected CAD. Methods and Results-Eighty-four patients referred for a primary diagnostic coronary angiography were examined with a 1.5 T MRI tomograph (Philips-ACS). For each heartbeat, 5 slices were acquired during the first pass of 0.025 mmol gadolinium-diethylenetriamine pentaacetic acid/kg body weight before and during adenosine vasodilation by using a turbo-gradient echo/echo-planar imaging-hybrid sequence. MPRI was determined from the alteration of the upslope of the myocardial signal intensity curves for 6 equiangular segments per slice. Receiver operating characteristics were performed for different criteria to differentiate ischemic and nonischemic segments. Prevalence of CAD was 51%. Best results were achieved when only the 3 inner slices were assessed and a threshold value of 1.1 was used for the second smallest value as a marker for significant CAD. This approach yielded a sensitivity of 88%, specificity of 90%, and accuracy of 89%. Conclusion-The determination of MPRI with MRI yields a high diagnostic accuracy in patients with suspected CAD.(Circulation. 2003;108:432-437.)

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“…Lately, DP with cardiac MRI has been investigated for the detection of coronary artery disease [14,15,18,[22][23][24], Baer et al [18] have reported the overall sensitivity of DP C-MRI for the detection of coronary artery disease to be 78%. They found the sensitivity/specificity of DP C-MRI for localization of the disease to range from 73/87 to 100/100% for the 3 main coronary artery territories.…”

Section: Resultsmentioning

confidence: 99%

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

Zegel¹,

Tuncalı²,

Beers³

et al. 1993

Am J Noninvas Cardiol

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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.

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MRI detection of myocardial perfusion changes by gadolinium‐DTPA infusion during dipyridamole hyperemia

Cited by 71 publications

References 13 publications

Arrhythmogenic right ventricular cardiomyopathy (ARVC): cardiovascular magnetic resonance update

Arrhythmogenic right ventricular cardiomyopathy (ARVC): cardiovascular magnetic resonance update

Magnetic Resonance Perfusion Measurements for the Noninvasive Detection of Coronary Artery Disease

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

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