title: Single-vessel coronary artery stenosis: myocardial perfusion imaging with Gadomer-17 first-pass MR imaging in a swine model of comparison with gadopentetate dimeglumine.
abstract: OBJECTIVE
  To evaluate the ability of Gadomer-17 to depict perfusion defects in a closed-chest swine model of single-vessel coronary artery disease.
  
  
  METHODS
  Twelve pigs underwent closed-chest placement of a flow reducer for 70%-90% luminal stenosis in the proximal left anterior coronary artery. Magnetic resonance (MR) perfusion imaging with Gadomer-17 and gadopentetate dimeglumine, microsphere blood flow (MBF) testing, and technetium 99m ((99m)Tc) 2 methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) were performed during dipyridamole vasodilation. Comparisons of percentage signal intensity (SI) increase (PSIC) in remote and ischemic myocardium were made with repeated measurements analysis of variance after injection of both tracers.
  
  
  RESULTS
  Perfusion defects and reduced PSIC in the anterior ischemic versus the inferior remote myocardium could be identified after injection of both Gadomer-17 (PSIC, 66% +/- 30 [mean +/- SD] vs 100% +/- 32, respectively; P <.001) and gadopentetate dimeglumine (PSIC, 49% +/- 31 vs 81% +/- 43, respectively; P <.005). The size of perfusion defect depicted with both tracers was highly correlated with defect size at (99m)Tc MIBI SPECT (r = 0.69, P <.05 for Gadomer-17 and r = 0.60, P =.05 for gadopentetate dimeglumine) and with areas of reduced MBF (r = 0.70, P <.05 for Gadomer-17 and r = 0.80, P <.05 for gadopentetate dimeglumine). PSIC also correlated with MBF (r = 0.89, P <.001 for Gadomer-17 and r = 0.75, P <.001 for gadopentetate dimeglumine). Gadomer-17 allowed differentiation of ischemic from nonischemic myocardium, as demonstrated by reduced PSIC (PSIC, 48% +/- 38 vs 72% +/- 31, respectively; P <.001) until 20 minutes after contrast material injection. In contrast, differentiation of ischemic from nonischemic myocardium was possible only until 55 seconds after injection of gadopentetate dimeglumine (PSIC, 36% +/- 24 vs 56% +/- 27, respectively; P <.005) but not at any time point thereafter.
  
  
  CONCLUSIONS
  With the study conditions, Gadomer-17 provided more prolonged differentiation of ischemic from remote myocardium than that with gadopentetate dimeglumine.
mesh_terms: D000818:Animals; D003287:Contrast Media; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D003331:Coronary Vessels / Q000473:pathology; D004176:Dipyridamole / Q000494:pharmacology; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D008279:Magnetic Resonance Imaging; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D019275:Radiopharmaceuticals; D013552:Swine; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C402765:gadomer 17; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; D005682:Gadolinium; D019786:Gadolinium DTPA