title: High spatial resolution myocardial perfusion cardiac magnetic resonance for the detection of coronary artery disease.
abstract: 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.
authors.affiliation: Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland. s.plein@leeds.ac.uk
authors.forename: Sven
authors.initials: S
authors.lastname: Plein
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kozerke
authors.forename: Daniel
authors.initials: D
authors.lastname: Suerder
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Luescher
authors.forename: John P
authors.initials: JP
authors.lastname: Greenwood
authors.forename: Peter
authors.initials: P
authors.lastname: Boesiger
authors.forename: Juerg
authors.initials: J
authors.lastname: Schwitter
mesh_terms: 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