title: Detection of regional myocardial perfusion deficit using rest and stress perfusion MRI: a feasibility study.
abstract: OBJECTIVE
  Providing high temporal and spatial resolution, perfusion MRI is an attractive alternative to traditional radionuclide methods like SPECT and PET. Although first-pass perfusion MRI examinations have gained increasing attention during the past years, this technique still exhibits relatively low signal-to-noise ratio and cardiac coverage. Previous studies have suggested that refocused gradient sequence technology (e.g., true fast imaging with steady-state precession [FISP]) should improve perfusion MRI examinations. The aim of this study was to assess myocardial perfusion deficits in patients with proven coronary artery disease using a saturation recovery true FISP perfusion sequence.
  
  
  METHODS
  Rest and stress perfusion MRI studies were performed in 22 patients with coronary artery disease at 1.5 T using a multislice saturation recovery true FISP sequence after the bolus injection of 0.025 mmol/kg of body weight of gadopentetate dimeglumine. The myocardium of each slice was divided into 12 radial segments with subdivision into subendocardial and subepicardial subregions. Myocardial perfusion was assessed semiquantitatively and independently for each subregion. The standard of reference for myocardial perfusion was SPECT. Delayed enhancement images were acquired after the injection of 0.15 mmol/kg of body weight of gadopentetate dimeglumine.
  
  
  RESULTS
  Sensitivity and specificity of perfusion MRI examinations for the detection of perfusion deficits were 81% and 89%, respectively, for the semiquantitative perfusion parameter upslope and 78% and 86% for the parameter peak signal intensity. More specifically, rest perfusion examinations were able to detect areas of infarction, whereas stress examinations increased the perfusion differences between normal and ischemic myocardial areas. Excellent correlation was observed between rest perfusion and late enhancement findings (r = 0.90).
  
  
  CONCLUSIONS
  In patients with single-vessel coronary artery disease, perfusion deficits can reliably be detected using a saturation recovery true FISP sequence. Semiquantitative perfusion parameters upslope and peak signal intensity yielded similar results.
authors.affiliation: Department of Diagnostic Radiology, Eberhard-Karls-University, Tuebingen 72076, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Fenchel
authors.forename: Uwe
authors.initials: U
authors.lastname: Helber
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kramer
authors.forename: Norbert I
authors.initials: NI
authors.lastname: Stauder
authors.forename: Andreas
authors.initials: A
authors.lastname: Franow
authors.forename: Claus D
authors.initials: CD
authors.lastname: Claussen
authors.forename: Stephan
authors.initials: S
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003326:Coronary Circulation; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA