Assessment of coronary flow reserve: comparison between contrast-enhanced magnetic resonance imaging and positron emission tomography

The study compared flow reserve indices by magnetic resonance imaging (MRI) with quantitative measures of coronary angiography and positron emission tomography (PET). The noninvasive evaluation of myocardial flow by MRI has recently been introduced. However, a comparison to quantitative flow measure...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of the American College of Cardiology Vol. 39; no. 5; pp. 864 - 870
Main Authors:	Ibrahim, Tareq, Nekolla, Stephan G., Schreiber, Karin, Odaka, Kenichi, Volz, Stefan, Mehilli, Julinda, Güthlin, Martin, Delius, Wolfram, Schwaiger, Markus
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 06-03-2002 Elsevier Science Elsevier Limited
Subjects:	Adult Aged Biological and medical sciences Blood Flow Velocity - physiology Cardiology Cardiology. Vascular system Cardiovascular disease Coronary Angiography Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - pathology Coronary Artery Disease - physiopathology Coronary Circulation - physiology Coronary heart disease Coronary vessels Female Heart Humans Magnetic Resonance Imaging Male Medical imaging Medical sciences Middle Aged NMR Nuclear magnetic resonance Ratios Sensitivity and Specificity Severity of Illness Index Tomography Tomography, Emission-Computed LCX MRI CAD ROC Gd-DTPA LV ROI CFR LAD RCA SI MI PET Radionuclide study Human Reserve Regional blood flow Prognosis Coronary artery Cardiovascular disease Coronary heart disease Nuclear magnetic resonance imaging Photon Medical imagery Comparative study Contrast media Emission tomography
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The study compared flow reserve indices by magnetic resonance imaging (MRI) with quantitative measures of coronary angiography and positron emission tomography (PET). The noninvasive evaluation of myocardial flow by MRI has recently been introduced. However, a comparison to quantitative flow measurement as assessed by PET has not been reported in patients with coronary artery disease (CAD). Two groups of healthy volunteers and 25 patients with angiographically documented CAD were examined by MRI and PET at rest and during adenosine stress. Dynamic MRI was performed using a multi-slice ultra-fast hybrid sequence and a rapid gadolinium-diethylenetriaminepenta-acetic acid bolus injection (0.05 mmol/l). Upslope and peak-intensity indices were regionally determined from first-pass signal intensity curves and compared to N-13 ammonia PET flow reserve measurements. In healthy volunteers, the upslope analysis showed a stress/rest index of 2.1 ± 0.6, which was higher than peak intensity (1.5 ± 0.3), but lower than flow reserve by PET (3.9 ± 1.1). Localization of coronary artery stenoses (>75%, MRI <1.2), based on the upslope index, yielded sensitivity, specificity and diagnostic accuracy of 69%, 89% and 79%, respectively. Upslope index correlated with PET flow reserve (r = 0.70). A reduced coronary flow reserve (PET <2.0, MRI <1.3) was detected by the upslope index with sensitivity, specificity and diagnostic accuracy of 86%, 84% and 85%, respectively. Magnetic resonance imaging first-pass perfusion measurements underestimate flow reserve values, but may represent a promising semi-quantitative technique for detection and severity assessment of regional CAD.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/S0735-1097(01)01829-0