Quantification of Myocardial Perfusion Reserve at 1.5 and 3.0 Tesla: a Comparison to Fractional Flow Reserve

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2012 Apr 6

PMID 22476908

Citations 12

Authors

Peter Bernhardt

Thomas Walcher

Wolfgang Rottbauer

Jochen Wohrle

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to compare quantitative analysis of cardiac magnetic resonance (CMR) perfusion at 1.5 and 3 T against fractional flow reserve (FFR) as measured invasively. FFR is considered by many investigators to be a reliable standard to determine hemodynamically significant coronary artery stenoses. Quantitative 1.5 and 3 T CMR is capable to noninvasively determine myocardial perfusion reserve, but have not been compared against each other and validated against FFR as standard reference. Patients with suspected or known coronary artery disease (CAD) underwent CMR at at both field strengths, 1.5 and 3 T, and FFR. 34 patients were included into the study. Quantitative myocardial perfusion reserve was calculated in 544 myocardial segments at 1.5 and 3 T, respectively. FFR was measured in 109 coronary arteries. FFR ≤ 0.8 was regarded relevant. Reduced FFR (≤0.8) was found in 38 coronary arteries (19 LAD, 8 LCX and 11 RCA). Receiver operator curve analysis yielded higher area under the curve for 3 T CMR in comparison to 1.5 T CMR (0.963 vs. 0.645, p < 0.001) resulting in higher sensitivity (90.5 vs. 61.9 %) and specificity (100 vs. 76.9 %). Quantitative analysis of CMR myocardial perfusion reserve at 1.5 and 3 T is capable to detect hemodynamic significance of coronary artery stenoses. Diagnostic accuracy at 3 T is to be superior to 1.5 T.

Citing Articles

Diagnostic and Prognostic Value of Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis.

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Diagnostic Accuracy of Cardiac Magnetic Resonance Versus Fractional Flow Reserve: A Systematic Review and Meta-Analysis.

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Importance of operator training and rest perfusion on the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance.

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Magnetic resonance Adenosine perfusion imaging as Gatekeeper of invasive coronary intervention (MAGnet): study protocol for a randomized controlled trial.

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References

Rieber J, Schiele T, Koenig A, Erhard I, Segmiller T, Stempfle H . Long-term safety of therapy stratification in patients with intermediate coronary lesions based on intracoronary pressure measurements. Am J Cardiol. 2002; 90(10):1160-4. DOI: 10.1016/s0002-9149(02)02790-x. View

Rieber J, Huber A, Erhard I, Mueller S, Schweyer M, Koenig A . Cardiac magnetic resonance perfusion imaging for the functional assessment of coronary artery disease: a comparison with coronary angiography and fractional flow reserve. Eur Heart J. 2006; 27(12):1465-71. DOI: 10.1093/eurheartj/ehl039. View

Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel P . Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation. 2001; 103(18):2230-5. DOI: 10.1161/01.cir.103.18.2230. View

Pijls N, Klauss V, Siebert U, Powers E, Takazawa K, Fearon W . Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter registry. Circulation. 2002; 105(25):2950-4. DOI: 10.1161/01.cir.0000020547.92091.76. View

Lee D, Simonetti O, Harris K, Holly T, Judd R, Wu E . Magnetic resonance versus radionuclide pharmacological stress perfusion imaging for flow-limiting stenoses of varying severity. Circulation. 2004; 110(1):58-65. DOI: 10.1161/01.CIR.0000133389.48487.B6. View

Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K . Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Circulation. 2003; 108(4):432-7. DOI: 10.1161/01.CIR.0000080915.35024.A9. View

Wen H, Denison T, Singerman R, Balaban R . The intrinsic signal-to-noise ratio in human cardiac imaging at 1.5, 3, and 4 T. J Magn Reson. 1997; 125(1):65-71. PMC: 2896425. DOI: 10.1006/jmre.1996.1072. View

Assmann G, Cullen P, Schulte H . Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Münster (PROCAM) study. Circulation. 2002; 105(3):310-5. DOI: 10.1161/hc0302.102575. View

Lockie T, Ishida M, Perera D, Chiribiri A, De Silva K, Kozerke S . High-resolution magnetic resonance myocardial perfusion imaging at 3.0-Tesla to detect hemodynamically significant coronary stenoses as determined by fractional flow reserve. J Am Coll Cardiol. 2010; 57(1):70-5. DOI: 10.1016/j.jacc.2010.09.019. View

10.

Costa M, Shoemaker S, Futamatsu H, Klassen C, Angiolillo D, Nguyen M . Quantitative magnetic resonance perfusion imaging detects anatomic and physiologic coronary artery disease as measured by coronary angiography and fractional flow reserve. J Am Coll Cardiol. 2007; 50(6):514-22. DOI: 10.1016/j.jacc.2007.04.053. View

11.

Pijls N, van Son J, Kirkeeide R, de Bruyne B, Gould K . Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation. 1993; 87(4):1354-67. DOI: 10.1161/01.cir.87.4.1354. View

12.

Ishida N, Sakuma H, Motoyasu M, Okinaka T, Isaka N, Nakano T . Noninfarcted myocardium: correlation between dynamic first-pass contrast-enhanced myocardial MR imaging and quantitative coronary angiography. Radiology. 2003; 229(1):209-16. DOI: 10.1148/radiol.2291021118. View

13.

Bernhardt P, Steffens M, Kleinertz K, Morell R, Budde R, Leischik R . Safety of adenosine stress magnetic resonance imaging using a mobile cardiac magnetic resonance system. J Cardiovasc Magn Reson. 2006; 8(3):475-8. DOI: 10.1080/10976640600575270. View

14.

Al-Saadi N, Nagel E, Gross M, Bornstedt A, Schnackenburg B, Klein C . Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance. Circulation. 2000; 101(12):1379-83. DOI: 10.1161/01.cir.101.12.1379. View

15.

Gibbons R . American Society of Nuclear Cardiology project on myocardial perfusion imaging: measuring outcomes in response to emerging guidelines. J Nucl Cardiol. 1996; 3(5):436-42. DOI: 10.1016/s1071-3581(96)90080-x. View

16.

Shaw L, Hachamovitch R, Heller G, Marwick T, Travin M, Iskandrian A . Noninvasive strategies for the estimation of cardiac risk in stable chest pain patients. The Economics of Noninvasive Diagnosis (END) Study Group. Am J Cardiol. 2000; 86(1):1-7. DOI: 10.1016/s0002-9149(00)00819-5. View

17.

Merkle N, Wohrle J, Grebe O, Nusser T, Kunze M, Kestler H . Assessment of myocardial perfusion for detection of coronary artery stenoses by steady-state, free-precession magnetic resonance first-pass imaging. Heart. 2007; 93(11):1381-5. PMC: 2016921. DOI: 10.1136/hrt.2006.104232. View

18.

Araoz P, Glockner J, McGee K, Potter Jr D, Valeti V, Stanley D . 3 Tesla MR imaging provides improved contrast in first-pass myocardial perfusion imaging over a range of gadolinium doses. J Cardiovasc Magn Reson. 2005; 7(3):559-64. DOI: 10.1081/jcmr-200060622. View

19.

Bernhardt P, Levenson B, Albrecht A, Engels T, Strohm O . Detection of cardiac small vessel disease by adenosine-stress magnetic resonance. Int J Cardiol. 2007; 121(3):261-6. DOI: 10.1016/j.ijcard.2006.11.008. View

20.

Ortiz-Perez J, Rodriguez J, Meyers S, Lee D, Davidson C, Wu E . Correspondence between the 17-segment model and coronary arterial anatomy using contrast-enhanced cardiac magnetic resonance imaging. JACC Cardiovasc Imaging. 2009; 1(3):282-93. DOI: 10.1016/j.jcmg.2008.01.014. View