[Evaluation of myocardial perfusion reserve in patients with CAD using contrast-enhanced MRI: a comparison between semiquantitative and quantitative methods].
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.
Schmitt
M
M
Klinik und Poliklinik für Radiologie, Johannes Gutenberg-Universität, Mainz, Germany. schmitt@radiologie.klinik.uni-mainz.de
Mohrs
O K
OK
Petersen
S E
SE
Kreitner
K F
KF
Voigtländer
T
T
Wittlinger
T
T
Horstick
G
G
Ziegler
S
S
Meyer
J
J
Thelen
M
M
Schreiber
W G
WG
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
D003287:Contrast Media; D019786:Gadolinium DTPA