adenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 t is...

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Journal of Cardiovascular Magnetic Resonance

Open AccessPoster presentationAdenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 T is not inferior to 1.5 TPeter Bernhardt*, Jochen Spieß, Robert Gradinger and Vinzenz Hombach

Address: University of Ulm, Ulm, Germany

* Corresponding author

IntroductionAdenosine-stress magnetic resonance imaging (CMR) at1.5 T has established for diagnosis of inducible myocar-dial ischemia in patients with suspected coronary arterydisease (CAD). However, little is known about feasibilityand accuracy of stress-perfusion performed at 3 T.

PurposeAim of our study was to compare 1.5 T and 3 T stress per-fusion for diagnosis of inducible myocardial ischemiarepresentative for coronary artery stenosis in patients withsuspected coronary artery disease.

MethodsPatients with clinical indication for coronary x-ray angiog-raphy underwent previously adenosine-stress CMR at 1.5T (Intera, Philips Medical Systems) and 3 T (Achieva,Philips Medical Systems) within 48 hours. Within 72hours after the last CMR examination coronary angiogra-phy was performed in these patients. A SSFP-basedsequence was used for perfusion imaging at 1.5 T and agradient-echo sequence at 3 T. Three short axis distributedalong the left ventricle were acquired, consequently afterthree minutes of adenosine infusion at a constant rate(140 µg/kg/min) to visualize myocardial first-pass of0.075 mmol/kg Gadolinium-based contrast agent(Dotarem, Guerbet). Ten minutes later the same per-fusion sequence using a second contrast bolus was per-formed during rest. All CMR images were analyzed by twoblinded and experienced readers in consensus for pres-ence of hypoperfusion during stress perfusion. Perfusionsequences were evaluated using the 17-segment-model. A

relevant stenosis was defined by QCA as luminal reduc-tion ≥70% in a vessel with ≥2 mm diameter.

Results123 perfusion territories of LAD, RCX and RCA were ana-lyzed. 11 territories were excluded due to poor imagequality in one of the examination at either magnetic fieldstrength. In 45 coronary arteries stenoses ≥70% werefound by coronary x-ray angiography. 1.5 T CMR stressperfusion yielded a sensitivity of 0.89, a specificity of 0.93and an overall accuracy of 0.91 for the diagnosis of coro-nary artery stenosis. Sensitivity of 3 T CMR stress per-fusion was 0.91, sensitivity 0.90 and overall accuracy0.90.

ConclusionAdenosine-stress CMR perfusion using a gradient-echosequence at 3 T is feasible for diagnosis of coronary arterystenosis and is not inferior to the established 1.5 T CMRstress perfusion. Further studies are warranted to evaluatewhether 3 T stress perfusion could be also used for quan-titative perfusion analysis and may even be superior to 1.5T examination.

from 13th Annual SCMR Scientific SessionsPhoenix, AZ, USA. 21-24 January 2010

Published: 21 January 2010

Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P215 doi:10.1186/1532-429X-12-S1-P215

<supplement> <title> <p>Abstracts of the 13^thAnnual SCMR Scientific Sessions - 2010</p> </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement>

This abstract is available from: http://jcmr-online.com/content/12/S1/P215

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