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- Open Access
High-resolution versus standard-resolution cardiovascular magnetic resonance perfusion imaging for the detection of coronary artery disease
Journal of Cardiovascular Magnetic Resonance volume 14, Article number: O89 (2012)
This study compared the diagnostic accuracy of high-resolution and standard-resolution cardiovascular magnetic resonance (CMR) perfusion imaging in patients with suspected coronary artery disease (CAD).
Although accelerated high-spatial-resolution CMR perfusion imaging has recently been shown to be clinically feasible, there has not yet been a direct comparison with standard-resolution methods. We hypothesised that higher spatial resolution detects more subendocardial ischemia and leads to greater diagnostic accuracy for the detection of angiographically defined CAD.
A total of 111 patients with suspected CAD were prospectively recruited. All patients underwent two separate perfusion CMR studies on a 1.5 Tesla CMR scanner (Intera CV, Philips Healthcare, Best, the Netherlands), one with standard-resolution (2.5 x 2.5mm in-plane resolution) and one with high-resolution (1.6 x 1.6mm in-plane resolution) acquisition. High-resolution acquisition was facilitated by eight-fold k-t broad linear speed up technique (BLAST) acceleration. Two observers visually graded perfusion in each myocardial segment on a 4-point scale. Segmental scores were summed to produce a perfusion score for each patient. All patients underwent invasive coronary angiography. Significant CAD was defined as a coronary artery stenosis of ≥ 50% diameter on quantitative coronary angiography.
CMR data were successfully obtained in 100 patients. A typical example is shown in Figure 1. In patients with CAD (n=70), more segments were determined to have subendocardial ischemia with high-resolution acquisition than with standard-resolution acquisition (279 vs.108; p<0.001). High-resolution acquisition had a greater diagnostic accuracy than standard-resolution acquisition for identifying single-vessel disease (area under the curve [AUC]: 0.88 vs. 0.73; p<0.001) or multi-vessel disease (AUC: 0.98 vs. 0.91; p=0.002) and overall (AUC: 0.93 vs. 0.83; p<0.001) (Figure 2).
Our study shows that high-resolution CMR perfusion imaging has greater diagnostic accuracy than standard-resolution acquisition for the detection of CAD in both single and multi-vessel disease and detects more subendocardial ischemia.
S.P is funded by a British Heart Foundation fellowship (FS/10/62/28409).
S.P and J.P.G received an unrestricted educational research grant from Philips Healthcare.
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Motwani, M., Maredia, N., Fairbairn, T. et al. High-resolution versus standard-resolution cardiovascular magnetic resonance perfusion imaging for the detection of coronary artery disease. J Cardiovasc Magn Reson 14, O89 (2012). https://doi.org/10.1186/1532-429X-14-S1-O89
- Coronary Artery Disease
- Cardiovascular Magnetic Resonance
- Invasive Coronary Angiography
- Significant Coronary Artery Disease
- Philips Healthcare