[MR stress perfusion for the detection of flow-limiting stenoses in symptomatic patients with known coronary artery disease and history of stent implantation].
OBJECTIVE
The aim of the present study was to determine the correlation of myocardial perfusion MR imaging (MPMRI) and coronary angiography for the detection of flow-limiting stenosis in symptomatic patients with known coronary artery disease and a history of intervention.


METHODS
MPMRI was performed in 51 symptomatic patients (44 male, 64.7 +/- 9.5 years) with known coronary artery disease and a history of stent implantation (between 5 years and 2 weeks prior to MRI). Malperfused myocardial regions were correlated with findings of coronary angiography. A stenosis of > 70% was regarded as hemodynamically significant.


RESULTS
In MPMRI 37 patients (73%) showed a stress induced perfusion deficit. In 35 of these patients coronary angiography revealed a stenosis of > 70 %. A total of 38 patients (75%) showed stenoses of > 70%. MPMRI yielded a sensitivity of 92% with a specificity of 85 %. The positive predictive value was 95 % and negative predictive value was 79%. The assignment of malperfused segments to coronary artery territories was carried out according to the standardized myocardial model of the American Heart Association (sensitivity/specificity was 59/85% for RCA, 79/81% for LAD and 54/68 % for LCX).


CONCLUSIONS
MPMRI is a suitable non-invasive method for detecting flow-limiting coronary artery stenoses in patients with a history of stent implantation.
Seeger
A
A
Radiologische Diagnostik, Universitätsklinikum Tübingen. achim.seeger@med.uni-tuebingen.de
Doesch
C
C
Klumpp
B
B
Kramer
U
U
Fenchel
M
M
Hoevelborn
T
T
Gawaz
M
M
Claussen
C D
CD
May
A E
AE
Miller
S
S
D000241:Adenosine; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000628:therapy*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015607:Stents; D013997:Time Factors; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D000241:Adenosine