High spatial resolution myocardial perfusion cardiac magnetic resonance for the detection of coronary artery disease.
OBJECTIVE
To evaluate the feasibility and diagnostic performance of high spatial resolution myocardial perfusion cardiac magnetic resonance (perfusion-CMR).


RESULTS
Fifty-four patients underwent adenosine stress perfusion-CMR. An in-plane spatial resolution of 1.4 × 1.4 mm(2) was achieved by using 5× k-space and time sensitivity encoding (k-t SENSE). Perfusion was visually graded for 16 left ventricular and two right ventricular (RV) segments on a scale from 0 = normal to 3 = abnormal, yielding a perfusion score of 0-54. Diagnostic accuracy of the perfusion score to detect coronary artery stenosis of >50% on quantitative coronary angiography was determined. Sources and extent of image artefacts were documented. Two studies (4%) were non-diagnostic because of k-t SENSE-related and breathing artefacts. Endocardial dark rim artefacts if present were small (average width 1.6 mm). Analysis by receiver-operating characteristics yielded an area under the curve for detection of coronary stenosis of 0.85 [95% confidence interval (CI) 0.75-0.95] for all patients and 0.82 (95% CI 0.65-0.94) and 0.87 (95% CI 0.75-0.99) for patients with single and multi-vessel disease, respectively. Seventy-four of 102 (72%) RV segments could be analysed.


CONCLUSIONS
High spatial resolution perfusion-CMR is feasible in a clinical population, yields high accuracy to detect single and multi-vessel coronary artery disease, minimizes artefacts and may permit the assessment of RV perfusion.
Plein
Sven
S
Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland. s.plein@leeds.ac.uk
Kozerke
Sebastian
S
Suerder
Daniel
D
Luescher
Thomas F
TF
Greenwood
John P
JP
Boesiger
Peter
P
Schwitter
Juerg
J
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity