- Oral presentation
- Open Access
Adenosine stress CMR with variable density spiral pulse sequences accurately detects CAD with minimal dark-rim artifacts
© Salerno et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Obstructive Coronary Artery Disease
- Saturation Recovery
- Reversible Perfusion Defect
- Late Gadolinium Enhance
- Isotropic Spatial Resolution
Adenosine stress CMR perfusion imaging has numerous advantages over competing modalities for assessing CAD demonstrating high diagnostic and prognostic utility. However, adenosine stress CMR perfusion imaging is limited by motion-induced dark-rim artifacts (DRA) which may be mistaken for true perfusion abnormalities. We have previously demonstrated that a high-resolution variable-density spiral pulse sequence with a novel density compensation strategy reduces ringing artifacts in first-pass perfusion imaging. The purpose of this study was to assess the clinical performance of this new technique to detect obstructive coronary artery disease (CAD).
CMR perfusion imaging was performed during adenosine stress (140 μg/kg-min) and at rest on a Siemens 1.5T Avanto scanner in 41 subjects with chest pain scheduled for coronary angiography (CA). Perfusion images were acquired during injection of 0.1 mmol/kg Gd-DTPA at 3 short-axis locations using a saturation recovery (SR) interleaved variable-density spiral pulse sequence. Sequence parameters included: SR time 80 ms, FOV 320-340 mm2, nominal resolution 2.0 mm2, 8 spiral interleaves, FA 30, TR/TE 9 ms/1 ms. Cine and late gadolinium enhanced (LGE) images were also obtained. All subjects underwent CA following the CMR and significant stenosis was defined as > 50% by quantitative CA. Two blinded reviewers evaluated the spiral perfusion images for the presence of adenosine-induced perfusion abnormalities and assessed image quality using a 5 point scale (1 - poor to 5- excellent).
This study is the first to clinically evaluate spiral pulse sequences for adenosine stress CMR. There are a number of advantages to spiral pulse sequences including high efficiency, high SNR efficiency, robustness to motion, and isotropic spatial resolution. We demonstrate that these sequences produce high quality images with minimal dark-rim artifacts and demonstrate high diagnostic accuracy for assessment of CAD.
AHA 10SDG2650038, NIH K23 HL112910-01, Siemens Medical Solutions.
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