High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent.
OBJECTIVE
Stress perfusion magnetic resonance imaging (MSPMRI) is an established technique for the assessment of myocardial perfusion. Shortcomings at 1.5 T are low signal to noise ratio (SNR) and contrast to noise ratio (CNR). One approach to overcome these shortcomings is to increase field strength and contrast concentration. The aim of our study was to investigate the diagnostic capability of high resolution MSPMRI at 3-T field strength using a 1 M contrast agent.


METHODS
Fifty-seven patients (62.3 +/- 11.0 years) with symptoms of coronary artery disease (CAD) were examined at 3 T. MMRSPI was assessed using a 2D saturation recovery gradient echo (SR GRE) sequence in short axis orientation (TR 1.9 ms, TE 1.0 ms, flip 12 degrees , 0.1 mmol gadobutrol/kg body weight (bw), 140 microg adenosine/kg bw/min). Perfusion images were assessed visually and semiquantitatively (upslope, peak signal intensity (SI), and myocardial perfusion reserve index (MPRI)). Standard of reference was invasive coronary angiography.


RESULTS
Stress-induced hypoperfusion was found in 43 patients. Sensitivity for hemodynamically relevant CAD (stenoses greater than 70%) was 95%/98%, specificity 80%/87%, diagnostic accuracy 91%/95% (reader 1/reader 2). The MPRI was significantly lower in hypoperfused myocardium (1.3 +/- 0.2) compared with normal myocardium (2.6 +/- 0.7).


CONCLUSIONS
High resolution MMRSPI at 3 T using 1 M contrast agent under daily routine conditions provides reliable detection of stress-induced myocardial hypoperfusion with higher diagnostic accuracy than 1.5-T conditions.
Klumpp
Bernhard D
BD
Department for Diagnostic Radiology, Eberhard Karls University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. bernhard.klumpp@med.uni-tuebingen.de
Seeger
Achim
A
Doesch
Christina
C
Doering
Joerg
J
Hoevelborn
Tobias
T
Kramer
Ulrich
U
Fenchel
Michael
M
Gawaz
Meinrad P
MP
Claussen
Claus D
CD
Miller
Stephan
S
D000241:Adenosine; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D055420:Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D000241:Adenosine