title: Endocardial and epicardial myocardial perfusion determined by semi-quantitative and quantitative myocardial perfusion magnetic resonance.
abstract: This study aims to quantify subendocardial and subepicardial myocardial blood flow (MBF) from dynamic contrast-enhanced MRI and to compare semi-quantitative and quantitative analysis methods. 17 healthy volunteers (9 males, mean age 34 ± 8) were scanned during adenosine stress and at rest. A "semi-quantitative" myocardial perfusion index (MPI) was calculated based on maximal upslopes of signal intensity-time profiles for a mid-ventricular myocardial slice. In addition, absolute MBF (ml/g/min) was estimated using Fermi-constrained deconvolution. On semi-quantitative analysis, the ratio of subendocardial to subepicardial MPI was 0.98 ± 0.1 at stress and 1.16 ± 0.09 at rest, P < 0.0001. The MPRI (i.e. the ratio of stress over rest MPI) for the subendocardium was 1.54 ± 0.3 versus 1.81 ± 0.35 for the subepicardium, P = 0.03. For quantitative analysis, the ratio of subendocardial to subepicardial MBF was 0.91 ± 0.11 at stress versus 1.17 ± 0.16 at rest, P < 0.0001. The subendocardial MBF reserve was also lower than in the subepicardium (2.6 ± 0.75 vs. 3.32 ± 0.93, P = 0.027). In conclusion, semi-quantitative and quantitative analysis of dynamic contrast-enhanced MRI shows higher subendocardial blood flow at rest and reduced subendocardial perfusion reserve compared to the subepicardium.
authors: Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK.
authors: Abdulghani
authors: A
authors: Larghat
authors: John
authors: J
authors: Biglands
authors: Neil
authors: N
authors: Maredia
authors: John P
authors: JP
authors: Greenwood
authors: Stephen G
authors: SG
authors: Ball
authors: Michael
authors: M
authors: Jerosch-Herold
authors: Aleksandra
authors: A
authors: Radjenovic
authors: Sven
authors: S
authors: Plein
mesh_terms: D000241:Adenosine; D000328:Adult; D016009:Chi-Square Distribution; D003287:Contrast Media; D003326:Coronary Circulation; D004699:Endocardium / Q000502:physiology*; D005260:Female; D019786:Gadolinium DTPA; D006439:Hemodynamics; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010496:Pericardium / Q000502:physiology*; D011237:Predictive Value of Tests; D012016:Reference Values; D012039:Regional Blood Flow; D012044:Regression Analysis; D013997:Time Factors; D014665:Vasodilator Agents; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media; D014665:Vasodilator Agents; D019786:Gadolinium DTPA; D000241:Adenosine