Noninvasive determination of regional myocardial perfusion with first-pass magnetic resonance (MR) imaging.
OBJECTIVE
To develop a method to provide absolute values of regional myocardial perfusion by means of color maps, and to determine myocardial perfusion reserve using magnetic resonance imaging during the first pass of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA).


METHODS
The study population consisted of five patients with hypertrophic cardiomyopathy, two with dilated cardiomyopathy, four with coronary artery disease, and one with normal coronary arteries who presented with mildly abnormal electrocardiogram findings. For each heartbeat, six continuous slices were acquired during the first pass of Gd-DTPA (0.05 mmol/kg body weight) before and during adenosine triphosphate (ATP) **stress using an electrocardiogram-triggered fast low-angle shot (FLASH) sequence on a 1.5-T magnetic resonance unit. Myocardial perfusion images were created and displayed by means of a color scale. The parameters were calculated pixel by pixel, using the upslope method. Myocardial perfusion reserve was then calculated, as the quotient of myocardial perfusion during ATP stress and perfusion before ATP stress.


RESULTS
Myocardial perfusion during ATP stress in patients with normal coronary arteries (n = 1) or after successful percutaneous coronary intervention (n = 2) was increased compared with that before ATP stress. However, the patients with coronary artery disease (n = 2) failed to show increased myocardial perfusion. The patients with hypertrophic cardiomyopathy showed increased myocardial perfusion during ATP stress, although two with dilated cardiomyopathy did not.


CONCLUSIONS
Our new technique can provide absolute values of regional myocardial perfusion by means of color maps, and has potential for widespread use for evaluation of ischemic and other types of heart disease.
Nakajima
Takahito
T
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3.39.22 Showa.machi, Maebashi, 371.8511, Japan.
Oriuchi
Noboru
N
Tsushima
Yoshito
Y
Funabasama
Shintaro
S
Aoki
Jun
J
Endo
Keigo
K
D000255:Adenosine Triphosphate; D000293:Adolescent; D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology; D002312:Cardiomyopathy, Hypertrophic / Q000503:physiopathology; D003287:Contrast Media; D003326:Coronary Circulation; D003327:Coronary Disease / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D000255:Adenosine Triphosphate; D019786:Gadolinium DTPA