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Assessment of myocardial perfusion for detection of coronary artery stenoses by steady-state, free-precession magnetic resonance first-pass imaging.
Merkle, Nico; Wöhrle, Jochen; Grebe, Olaf; Nusser, Thorsten; Kunze, Markus; Kestler, Hans A; Kochs, Matthias; Hombach, Vinzenz.
Afiliação
  • Merkle N; Department of Internal Medicine II, University of Ulm, Robert-Koch-Strasse-8, 89081 Ulm, Germany.
Heart ; 93(11): 1381-5, 2007 Nov.
Article em En | MEDLINE | ID: mdl-17488772
ABSTRACT

OBJECTIVE:

To evaluate the diagnostic impact of magnetic resonance imaging (MRI) first-pass perfusion using steady-state, free-precession (SSFP) sequences with parallel imaging (SENSE) for detection of coronary stenoses.

DESIGN:

Prospective observational study.

SETTING:

University hospital, cardiac MRI and catheterisation laboratories. PATIENTS AND

METHODS:

228 patients were examined with coronary angiography and MRI (1.5 T Intera CV). A three-slice, short-axis SSFP perfusion scan with a saturation prepulse was performed during infusion of adenosine and at rest followed by myocardial scar (late enhancement) imaging. Gadolinium-DTPA was given at 0.1 mmol/kg body weight. Perfusion images were visually assessed. Analysis for myocardial hypoperfusion was done according to patient group and according to vessel.

RESULTS:

Sensitivity, specificity and accuracy of MRI first-pass perfusion for detection of a coronary artery stenosis (>50% luminal narrowing) in the total patient group were 93.0%, 85.7%, 91.2% and for a significant lesion (>70% luminal narrowing) 96.1%, 72.0%, 88.2%, respectively. Based on 536 coronary artery territories without myocardial scar, the sensitivity of MRI perfusion analysis for detection of a significant lesion was for the left anterior descending artery 91.4%, for the circumflex artery 81.6% and for the right coronary artery 65.1% (p<0.001).

CONCLUSIONS:

MRI first-pass perfusion analysis using an SSFP sequence with three myocardial slices was a highly accurate diagnostic method for detection of coronary artery stenoses. This MRI technique can be included in daily practice and has the potential to guide the indication for invasive coronary angiography.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Angiografia por Ressonância Magnética / Estenose Coronária Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Alemanha

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Angiografia por Ressonância Magnética / Estenose Coronária Tipo de estudo: Diagnostic_studies / Evaluation_studies / Observational_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2007 Tipo de documento: Article País de afiliação: Alemanha