High-resolution free-breathing automated quantitative myocardial perfusion by cardiovascular magnetic resonance for the detection of functionally significant coronary artery disease.
Eur Heart J Cardiovasc Imaging
; 25(7): 914-925, 2024 Jun 28.
Article
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| MEDLINE
| ID: mdl-38525948
ABSTRACT
AIMS:
Current assessment of myocardial ischaemia from stress perfusion cardiovascular magnetic resonance (SP-CMR) largely relies on visual interpretation. This study investigated the use of high-resolution free-breathing SP-CMR with automated quantitative mapping in the diagnosis of coronary artery disease (CAD). Diagnostic performance was evaluated against invasive coronary angiography (ICA) with fractional flow reserve (FFR) measurement. METHODS ANDRESULTS:
Seven hundred and three patients were recruited for SP-CMR using the research sequence at 3 Tesla. Of those receiving ICA within 6 months, 80 patients had either FFR measurement or identification of a chronic total occlusion (CTO) with inducible perfusion defects seen on SP-CMR. Myocardial blood flow (MBF) maps were automatically generated in-line on the scanner following image acquisition at hyperaemic stress and rest, allowing myocardial perfusion reserve (MPR) calculation. Seventy-five coronary vessels assessed by FFR and 28 vessels with CTO were evaluated at both segmental and coronary territory level. Coronary territory stress MBF and MPR were reduced in FFR-positive (≤0.80) regions [median stress MBF 1.74 (0.90-2.17) mL/min/g; MPR 1.67 (1.10-1.89)] compared with FFR-negative regions [stress MBF 2.50 (2.15-2.95)â mL/min/g; MPR 2.35 (2.06-2.54) P < 0.001 for both]. Stress MBF ≤ 1.94â mL/min/g and MPR ≤ 1.97 accurately detected FFR-positive CAD on a per-vessel basis (area under the curve 0.85 and 0.96, respectively; P < 0.001 for both).CONCLUSION:
A novel scanner-integrated high-resolution free-breathing SP-CMR sequence with automated in-line perfusion mapping is presented which accurately detects functionally significant CAD.Palabras clave
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Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Angiografía Coronaria
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Imagen por Resonancia Cinemagnética
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Reserva del Flujo Fraccional Miocárdico
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Año:
2024
Tipo del documento:
Article