Noninvasive stress testing of myocardial ischemia: comparison of GRE-MRI perfusion and wall motion analysis to 99 mTc-MIBI-SPECT, relation to coronary angiography.
In the evaluation of ischemic heart disease only MR imaging seems to have the potential to assess myocardial perfusion, function, and coronary morphology on a single instrument. The aim of this study was to assess the feasibility of a stress test with dipyridamole (0. 56 mg/kg) to analyze myocardial perfusion by Gd first-pass enhancement in ultrafast gradient-recalled-echo MRI (perf-MRI), and wall motion by cine gradient-recalled-echo MRI (Cine-MRI) in one imaging session. Twelve patients underwent complete rest and stress studies; satisfactory MR images were acquired in 10 patients. By 99 mTc-MIBI-SPECT sensitivities to detect ischemic segments were 66.7 % with Perf-MRI, 80.0 % with WM-MRI and 86.7 % for Perf-WM-MRI (Perf-MRI vs Perf-WM-MRI; p = 0.03). Scar was equally detected with a sensitivity of 91.6 % with either MRI technique. Thus, Perf-Cine-MRI provides complementary information for the management of ischemic heart disease and has a higher sensitivity than Perf-MRI alone.
Bremerich
J
J
Department of Radiology, University Hospital, CH-4031 Basel, Switzerland.
Buser
P
P
Bongartz
G
G
Müller-Brand
J
J
Grädel
C
C
Pfisterer
M
M
Steinbrich
W
W
D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004176:Dipyridamole; D004562:Electrocardiography; D005240:Feasibility Studies; D005682:Gadolinium; D006571:Heterocyclic Compounds; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009942:Organometallic Compounds; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; D014665:Vasodilator Agents; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate; D005682:Gadolinium