title: High spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance using k-t SENSE.
abstract: OBJECTIVE
  To prospectively evaluate the feasibility and diagnostic accuracy of high spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance (DSMR) for the detection of coronary artery disease (CAD).
  
  
  RESULTS
  DSMR-wall motion was combined with perfusion imaging (DSMR-perfusion) in 78 patients prior to clinically indicated invasive coronary angiography. For DSMR-perfusion an in-plane spatial resolution of 1.5 × 1.5mm(2) was attained by using 8 × k-space and time sensitivity encoding (k-t SENSE). Image quality and extent of artifacts during perfusion imaging were evaluated. Wall motion and perfusion data were interpreted sequentially. Significant CAD (stenosis ≥ 70%) was present in 52 patients and involved 86 coronary territories. One patient did not reach target heart rate despite maximum infusion of dobutamine/atropine. Two studies (3%) were non-diagnostic due k-t SENSE related artifacts resulting from insufficient breathhold capability. Overall image quality was good. Dark-rim artifacts were limited to the endocardial border at a mean width of 1.8mm. The addition of DSMR-perfusion to DSMR-wall motion data improved sensitivity for the detection of CAD (92% vs. 81%, P=0.03) and accurate determination of disease extent (85% vs. 66% of territories, P<0.001). There were no significant differences between DSMR-perfusion and DSRM-wall motion regarding overall specificity (83% vs. 87%, P=1) and accuracy (89% vs. 83%, P=0.13).
  
  
  CONCLUSIONS
  High spatial resolution DSMR-perfusion imaging at maximum stress level was feasible, improved sensitivity over DSMR-wall motion for the detection of CAD and allowed an accurate determination of disease extent. Specificity of DSMR-perfusion with k-t SENSE improved compared to prior studies using lower spatial resolution.
authors.affiliation: German Heart Institute Berlin, Germany. gebker@dhzb.de
authors.forename: R
authors.initials: R
authors.lastname: Gebker
authors.forename: C
authors.initials: C
authors.lastname: Jahnke
authors.forename: R
authors.initials: R
authors.lastname: Manka
authors.forename: M
authors.initials: M
authors.lastname: Frick
authors.forename: T
authors.initials: T
authors.lastname: Hucko
authors.forename: S
authors.initials: S
authors.lastname: Kozerke
authors.forename: B
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: E
authors.initials: E
authors.lastname: Fleck
authors.forename: I
authors.initials: I
authors.lastname: Paetsch
mesh_terms: D000368:Aged; D016477:Artifacts; D001285:Atropine / Q000008:administration & dosage; D057791:Cardiac Imaging Techniques / Q000379:methods*; D002316:Cardiotonic Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D004280:Dobutamine / Q000008:administration & dosage; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D002316:Cardiotonic Agents; D018727:Muscarinic Antagonists; D004280:Dobutamine; D001285:Atropine