Blood oxygen level-dependent magnetic resonance imaging using T2-prepared steady-state free-precession imaging in comparison to contrast-enhanced myocardial perfusion imaging.
BACKGROUND
Diagnosis of inducible myocardial ischemia is important for deciding further diagnosis and therapy in coronary artery disease (CAD). Blood oxygen level-dependent (BOLD) cardiac magnetic resonance imaging (CMR) is a potential method to evaluate myocardial perfusion reserve alternatively to first-pass perfusion using contrast agents.


RESULTS
We imaged 46 patients with suspected CAD on a 1.5 T whole-body CMR scanner using a T2-prepared steady-state free-precession (SSFP) BOLD-sensitive sequence and a SSFP-based first-pass sequence. All patients were scanned during rest and after 3 min of adenosine infusion (140 µg/kg/min). For myocardial first-pass visualization 0.1 mmol/kg Gadolinium-based contrast agent was used. In 90 myocardial segments a first-pass perfusion deficit could be seen. Relative BOLD signal increase was significantly lower in patients with perfusion deficits compared to patients without perfusion deficits (p < 0.0001). Patients with non-transmural and with transmural first-pass perfusion deficit also differed significantly for BOLD signal increase (p < 0.0001). ROC analysis showed an area under the curve of 0.83 for the T2-prepared SSFP sequence regarding detection of inducible perfusion deficit.


CONCLUSIONS
T2-prepared BOLD imaging allows for visualization of myocardial perfusion reserve in a clinical setting without additional use of contrast agents.
Bernhardt
Peter
P
Department of Internal Medicine II, University of Ulm, Robert-Koch-Str 8, 89081 Ulm, Germany. peter.bernhardt@uniklinik-ulm.de
Manzke
Robert
R
Bornstedt
Axel
A
Gradinger
Robert
R
Spiess
Jochen
J
Walcher
Daniel
D
Rasche
Volker
V
Hombach
Vinzenz
V
D000368:Aged; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009206:Myocardium / Q000378:metabolism; D010100:Oxygen / Q000097:blood*
D010100:Oxygen