Diagnostic accuracy of stress first-pass contrast-enhanced myocardial perfusion MRI compared with stress myocardial perfusion scintigraphy.
OBJECTIVE
The purpose of this study was to determine the diagnostic accuracy of stress perfusion MRI acquired with saturation-recovery prepared turbo fast low-angle shot (turbo FLASH) compared with stress myocardial perfusion scintigraphy. Recent studies show that first-pass contrast-enhanced myocardial perfusion MRI can provide noninvasive detection of low-limiting stenosis in the coronary artery.


METHODS
First-pass contrast-enhanced MR images were acquired at rest and during stress in 40 patients with suspected coronary artery disease. All patients underwent thallium-201 SPECT without attenuation correction and coronary angiography. Two reviewers independently assigned one of five confidence grades without knowing the results of coronary angiography for receiver operating characteristic (ROC) analysis. Luminal stenosis >70% on coronary angiography was used as a reference standard.


RESULTS
On coronary angiography, 70% or greater diameter stenosis of the coronary artery was observed in 21 (52.5%) of 40 patients. The areas under the ROC curve for detection of significant stenosis in the individual coronary artery were 0.86 (observer 1) and 0.84 (observer 2) for MRI. These values were 0.79 (observer 1, p = not significant) and 0.72 (observer 2, p = not significant) for 201Tl SPECT.


CONCLUSIONS
The diagnostic accuracy of stress perfusion MRI acquired with saturation-recovery-prepared turbo FLASH was comparable with that of stress 201Tl SPECT. Stress first-pass contrast-enhanced MRI is a noninvasive technique that can be used as an alternative to stress myocardial perfusion scintigraphy.
Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. sakuma@clin.medic.mie-u.ac.jp
Hajime
H
Sakuma
Naohisa
N
Suzawa
Yasutaka
Y
Ichikawa
Katsutoshi
K
Makino
Tadanori
T
Hirano
Kakuya
K
Kitagawa
Kan
K
Takeda
D003287:Contrast Media; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013793:Thallium; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D003287:Contrast Media; D013794:Thallium Radioisotopes; C027549:thallium chloride; D004176:Dipyridamole; D013793:Thallium; D019786:Gadolinium DTPA