[MRI first-pass myocardial perfusion in patients undergoing percutaneous myocardial laser revascularization].
OBJECTIVE
Evaluation of MRI first-pass myocardial perfusion pre- and post-percutaneous myocardial laser revascularisation (PMR).


METHODS
MRI was performed in 10 patients with coronary heart disease grade III-IV, 1-4 days prior to PMR, as well as 1-5 days and 6 months after PMR. Contrast enhanced (0.1 ml/kgBw; 4 ml/s) "first-pass" MRI imaging was obtained by breath-hold, ECG-triggered, multislice Turbo-FLASH GRE. For quantitative analysis the absolute and percentual signal-to-noise (S/N)-measurements were calculated. Positron emission tomography (PET) was regarded as the gold standard for myocardial perfusion.


RESULTS
The mean values of absolute and % S/N increase revealed no statistical difference between pre- and immediately post-PMR imaging. 6 months following PMR both values were significantly elevated (14.1 vs. 24.4 and 127 vs. 176; p = 0.03 and p = 0.01). However, the non-treated myocardial segments revealed a similar S/N pattern. Intraindividual analysis showed a significant S/N increase post PMR in one patient, and in additional 4 patients 6 months later. PET revealed increased myocardial perfusion in only two patients. Following PMR 5/10 patients experienced a significant reduction of chest pain equivalent to two CCS grades. Two of these had significant S/N elevations but no evidence of increased perfusion by PET.


CONCLUSIONS
S/N first-pass calculations following PMR do not correlate well with the true situation of myocardial perfusion. They seem to be more closely associated with other histological phenomena and possible explanations for the improved clinical symptomatology.
Weber
C
C
Radiologische Klinik und Poliklinik, Abteilung für Röntgendiagnostik, Universitätsklinikum Hamburg Eppendorf. C.Weber@uke.uni-hamburg.de
Steiner
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P
Baldus
S
S
Pourtehrani
P Y
PY
Adam
G
G
D000368:Aged; D003326:Coronary Circulation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009204:Myocardial Revascularization / Q000379:methods*; D013997:Time Factors; D014055:Tomography, Emission-Computed