Blood oxygen level-dependent magnetic resonance imaging in patients with stress-induced angina.
BACKGROUND
Blood oxygen level-dependent (BOLD) MRI reflects tissue oxygenation and may be useful for the detection of myocardial ischemia in patients with suspected coronary artery disease.


RESULTS
We studied 25 patients with stress-induced angina using a T2*-sensitive echo planar imaging sequence before and during adenosine in a single-slice approach. BOLD-MRI results were compared with quantitative angiography and adenosine thallium single-photon emission computed tomography (SPECT). Although image quality was variable because of artifacts, no data were excluded from the analysis. During adenosine, a mean signal intensity decrease was observed for myocardial segments related to coronary stenoses >75%. On average, a nonsignificant increase was observed in the other segments. The angiographically determined stenosis was correlated with BOLD-MRI results. Including all segments and using BOLD-MRI signal intensity increase cutoff value of 1.2%, BOLD-MRI had a sensitivity of 88% and a specificity of 47% to correctly classify severe stenoses. Adenosine thallium SPECT data from distal segments of the same coronary territory were also correlated with BOLD-MRI. However, variability was substantial.


CONCLUSIONS
In patients with stress-induced angina, adenosine BOLD-MRI detects myocardial ischemia in myocardial segments related to severe coronary stenoses. Its potential will increase with additional improvement of spatial coverage and image quality.
Friedrich
Matthias G
MG
Helios-Klinikum Berlin, Franz-Volhard-Klinik, Kardiologie Charité Campus Berlin-Buch, Medizinische Fakultaet der Humboldt-Universitaet Berlin, Germany. friedrich@fvk-berlin.de
Niendorf
Thoralf
T
Schulz-Menger
Jeanette
J
Gross
C Michael
CM
Dietz
Rainer
R
D000241:Adenosine; D000787:Angina Pectoris / Q000097:blood* / Q000175:diagnosis*; D017023:Coronary Angiography; D005080:Exercise Test; D005240:Feasibility Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013312:Stress, Physiological; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes; D000241:Adenosine; D010100:Oxygen