Single- or dual-bolus approach for the assessment of myocardial perfusion reserve in quantitative MR perfusion imaging.
A dual-bolus protocol can overcome limitations due to T1-induced MR signal attenuation and hence enables more accurate quantification of myocardial blood flow (MBF) by contrast enhanced MR perfusion imaging. The study explores potential benefits of the dual-bolus technique for the assessment of myocardial perfusion reserve (MPR) over a standard single-bolus protocol. Nineteen patients without obstructive coronary artery disease as assessed by cardiac catheterization underwent a stress-rest MR perfusion study using a dual-bolus protocol. Gd-DTPA dosages of 0.005 and 0.05 mmol/kg of bodyweight were delivered as pre- and main-bolus. For comparison arterial input curves where extracted from left ventricular cavity passage including both, pre-bolus and main-bolus data. Global and segmental MPR were determined from semiquantitative and from full quantitative measures of MBF. As a result good agreement between dual- and single-bolus technique was found with relative differences of maximally 10% in global MPR estimates. For the dual bolus approach a significant relative decrease of 30% (P<0.001) was found for the coefficient of segmental MPR variation, which may allow a more reliable detection of hypoperfused segments in clinical studies.
Utz
Wolfgang
W
Franz Volhard Klinik, Charite Campus Buch, HELIOS Klinikum-Berlin at the Max Delbrück Center for Molecular Medicine, Berlin, Germany. wolfgang.utz@charite.de
Greiser
Andreas
A
Niendorf
Thoralf
T
Dietz
Rainer
R
Schulz-Menger
Jeanette
J
D000704:Analysis of Variance; D003287:Contrast Media / Q000008:administration & dosage*; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D019786:Gadolinium DTPA