Myocardial perfusion magnetic resonance imaging for diagnosing coronary arterial stenosis.
It has been reported that myocardial perfusion MRI is a useful method for evaluating the severity of myocardial ischemia. We evaluated whether the severity of coronary arterial stenosis could be assessed by the signal-intensity time curve (SITC) obtained by myocardial perfusion MRI. The subjects consisted of 10 patients who showed no abnormalities on coronary angiographies (CAG) (A group), 12 with single-vessel disease of 75-90% stenosis on CAG (B group), and 15 with single-vessel disease of 90% or more stenosis (C group). After infusion of dipyridamole for 4 minutes, gadolinium-diethylenetriamine pentaacetic acid was administered intravenously, followed by serial acquisition of T1-weighted left ventricular short-axis MR images. These images were evaluated after dividing them into the following 3 myocardial segments: anterior wall, lateral wall, and inferior wall. Mean values of the slope of SITC ( 1.4 +/- 0.2 vs 1.1 +/- 0.2. P < 0.01), and increases to the peak corrected SI (deltaSI) (47.5 +/- 1.9 % vs 33.7 +/- 2.4%, P < 0.01) in normal myocardial segments were significantly greater than in ischemic segments in the C group, while there was no significant distinction between normal and ischemic segments in the B group. The mean values of time to the peak SI were not significantly different between normal and ischemic regions in the B and C groups. The results suggest that myocardial segments exhibiting 30% decreases in both the slope and deltaSI of SITC can be diagnosed as having 90% or more severe coronary stenosis. The present study shows that visual and SITC evaluations of myocardial perfusion MR images may be useful for clinically evaluating the severity of coronary stenosis.
Kinoshita
Manabu
M
Division of Cardiology, Kagawa Prefectural Shirotori Hospital, Matsubara, Okawa-gun 769-2788, Japan.
Nomura
Masahiro
M
Harada
Masafumi
M
Bando
Shigenobu
S
Nakaya
Yutaka
Y
Ito
Susumu
S
D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted