title: Myocardial perfusion reserve assessed by T2-prepared steady-state free precession blood oxygen level-dependent magnetic resonance imaging in comparison to fractional flow reserve.
abstract: BACKGROUND
  Blood oxygen level-dependent (BOLD) cardiac magnetic resonance imaging (CMR) has been shown to be able to detect myocardial perfusion differences. However, validation of BOLD CMR against fractional flow reserve (FFR) is lacking. The aim of our study was to analyze the potential diagnostic accuracy of BOLD CMR in comparison to invasively measured FFR, which served as gold standard for a hemodynamic significant coronary lesion.
  
  
  RESULTS
  BOLD image was performed at rest and during adenosine infusion in a 1.5-T CMR scanner. Thirty-six patients were analyzed for relative BOLD signal intensity increase according to the 16-segment model. Invasive FFR measurements were performed in the 3 major coronary arteries during adenosine infusion in all patients. An FFR≤0.8 was regarded to indicate a significant coronary lesion. Relative BOLD signal intensity increase was significantly lower in myocardial segments supplied by coronary arteries with an FFR≤0.8 compared with segments with an FFR>0.8 (1.1±0.2 versus 1.5±0.2; P<0.0001). Sensitivity and specificity yielded 88.2% and 89.5%, respectively.
  
  
  CONCLUSIONS
  CMR BOLD imaging reliably detects hemodynamic significant coronary artery disease and is, thus, an alternative to contrast-enhanced perfusion studies.
authors.affiliation: Department of Internal Medicine II, University of Ulm, Albert-Einstein-Allee 2, Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Walcher
authors.forename: Robert
authors.initials: R
authors.lastname: Manzke
authors.forename: Vinzenz
authors.initials: V
authors.lastname: Hombach
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
authors.forename: Peter
authors.initials: P
authors.lastname: Bernhardt
mesh_terms: D000241:Adenosine; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial; D005858:Germany; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D009206:Myocardium / Q000378:metabolism*; D010100:Oxygen / Q000097:blood*; D010108:Oxyhemoglobins / Q000378:metabolism; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014665:Vasodilator Agents
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D010108:Oxyhemoglobins; D014665:Vasodilator Agents; C100003:deoxyhemoglobin; D000241:Adenosine; D010100:Oxygen