Cardiac MRI in ischemic heart disease with severe coronary artery stenosis.
OBJECTIVE
The aim was to evaluate the left ventricular wall motion abnormalities, perfusion and late contrast enhancement patterns on magnetic resonance imaging (MRI) in patients with 70% or higher degree stenosis or occlusion of coronary arteries on coronary angiography.


METHODS
Twenty-four patients (5 women, 19 men, age range 38-78, mean age 59.1) who had 70% or higher degree stenosis or occlusion of coronary arteries on coronary angiography who had been referred for cardiac MRI were included. On coronary angiography, 20 vessels were totally occluded [left anterior descending artery (LAD) 12; left circumflex coronary artery (LCx) 2; right coronary artery 6] and 20 vessels were severely stenotic (70-99%). In 5 patients' three vessels, in 6 patients' two vessels, and in 13 patients' a single vessel was involved. Wall motion, perfusion abnormalities, and late contrast enhancement consistent with nonviable myocardium were analyzed at apical, at midventricular, and basal levels on short-axis images of cardiac MRI in concordance with the segmental irrigation areas of the coronary arteries.


RESULTS
Impaired perfusion was observed on the corresponding irrigation segments of 39 vessels of 40 coronary artery branches. Wall motion abnormalities were present on corresponding irrigation areas of 30 severely stenotic vessels. Combined evaluation of wall motion and perfusion, segments with the decreased left ventricular contraction, and perfusion matched with the corresponding irrigation areas of all of the 40 stenotic or occluded vessels.


CONCLUSIONS
A correlation was found between the combined assessments of myocardial perfusion, wall motion, and viability on late contrast enhancement on cardiac MRI with the clinical and angiography findings. Thus this combined MRI protocol can be used for the evaluation of ischemic heart disease.
Unlu
Muharrem
M
Radiology Department, Kocaeli University School of Medicine, 41380, Umuttepe, Kocaeli, Turkey.
Anik
Yonca
Y
Demirci
Ali
A
Ural
Dilek
D
Kahraman
Goksel
G
Komsuoglu
Baki
B
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D010477:Perfusion; D012107:Research Design; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D003287:Contrast Media; D019786:Gadolinium DTPA