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Adenosine-induced stress myocardial perfusion MRI using SW-CG-HYPR with whole left ventricular coverage: comparison of results with X-ray angiography in patients with suspected CAD

Introduction

Myocardial perfusion MRI with sliding-window conjugate-gradient HYPR (SW-CG-HYPR) allows increased spatial coverage (whole left ventricular coverage), resolution, signal-to-noise ratio and reduced motion artifacts. The accuracy of this technique for detecting coronary artery disease (CAD) has not been determined in a large number of patients.

Purpose

The purpose of this study was to prospectively evaluate the diagnostic performance of adenosine-induced stress myocardial perfusion MRI with SW-CG-HYPR in patients with suspected CAD.

Methods

Forty consecutive patients (23 men and 17 women; mean age, 56 ± 15 years) with suspected CAD who were scheduled for coronary angiography underwent myocardial adenosine stress perfusion MRI with SW-CG-HYPR at 3.0T. Perfusion defects were interpreted visually by 2 blinded observers and were correlated to x-ray angiographic stenoses ≥ 50%.

Results

The prevalence of CAD was 55%. In the per-patient analysis, the sensitivity, specificity and accuracy of SW-CG-HYPR myocardial perfusion imaging were 95%, 83% and 90%, respectively. In the per-vessel analysis, these values were 98%, 89% and 93%, respectively. Figure 1 illustrates the detection of significant CAD by SW-CG-HYPR myocardial perfusion imaging with correlation to X-ray coronary angiography.

Figure 1
figure1

A 56-year-old man with no prior cardiac history who presented with chest pain. (A) Myocardial perfusion MRI with sliding-window conjugate-gradient HYPR (SW-CG-HYPR) detects perfusion defects in the basal, mid, and apical lateral segments, corresponding to significant stenoses in the left circumflex coronary artery (LCX). (B) Coronary angiography (CA) confirms significant stenoses in the LCX.

Conclusions

Adenosine-Induced stress myocardial perfusion MRI using SW-CG-HYPR allows whole left ventricular coverage and has high diagnostic accuracy in patients with suspected CAD.

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Correspondence to Heng Ma.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Ma, H., Ge, L., An, J. et al. Adenosine-induced stress myocardial perfusion MRI using SW-CG-HYPR with whole left ventricular coverage: comparison of results with X-ray angiography in patients with suspected CAD. J Cardiovasc Magn Reson 13, P78 (2011). https://doi.org/10.1186/1532-429X-13-S1-P78

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Keywords

  • Coronary Artery Disease
  • Myocardial Perfusion
  • Myocardial Perfusion Imaging
  • Perfusion Defect
  • Significant Coronary Artery Disease