title: [Evaluation of myocardial perfusion reserve in patients with CAD using contrast-enhanced MRI: a comparison between semiquantitative and quantitative methods].
abstract: OBJECTIVE
  Comparison between two semiquantitative methods and a quantitative evaluation of myocardial blood flow (MBF) for assessment of myocardial perfusion reserve (MPR) in patients with CAD.
  
  
  METHODS
  9 patients with coronary stenoses > 50 % were examined with an ECG-gated Saturation Recovery Turbo FLASH sequence by using Gd-DTPA as contrast agent (CA). The entive measurements were performed both during rest and hyperemia induced by adenosine. The up-slopes of the signal-time S(t) curves in the myocardium and left ventricular (LV) cavity were evaluated by a linear fit. MPR was calculated from the original up-slopes of the myocardial S(t) curves and from the up-slopes, which were normalized to the up-slopes of the LV S(t) curves, respectively. For quantification of MBF values, the mathematical model MMID 4 was used and MPR was evaluated from the MBF values.
  
  
  RESULTS
  With all tested methods, MPR was reduced in myocardial regions subtended by arteries with stenoses >/= 70 % compared with remote regions. With MMID 4 and the normalized up-slope method, differences between severe ischemic and remote regions were statistically significant.
  
  
  CONCLUSIONS
  The up-slope method with normalization and quantification with MMID 4 are more sensitive methods to differentiate between remote and ischemic myocardium than the up-slope method without normalization.
authors.affiliation: Klinik und Poliklinik für Radiologie, Johannes Gutenberg-Universität, Mainz, Germany. schmitt@radiologie.klinik.uni-mainz.de
authors.forename: M
authors.initials: M
authors.lastname: Schmitt
authors.forename: O K
authors.initials: OK
authors.lastname: Mohrs
authors.forename: S E
authors.initials: SE
authors.lastname: Petersen
authors.forename: K F
authors.initials: KF
authors.lastname: Kreitner
authors.forename: T
authors.initials: T
authors.lastname: Voigtländer
authors.forename: T
authors.initials: T
authors.lastname: Wittlinger
authors.forename: G
authors.initials: G
authors.lastname: Horstick
authors.forename: S
authors.initials: S
authors.lastname: Ziegler
authors.forename: J
authors.initials: J
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Thelen
authors.forename: W G
authors.initials: WG
authors.lastname: Schreiber
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003326:Coronary Circulation / Q000502:physiology*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012146:Rest
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA