Objective: To evaluate the diagnostic impact of magnetic resonance imaging (MRI) first-pass perfusion using a steady-state-free-precession (SSFP) sequences with parallel imaging (SENSE) for detection of coronary stenoses.
Design: Prospective observational study.
Setting: University hospital, cardiac MRI and catheterization labs.
Patients and methods: 228 patients were examined with coronary angiography and MRI (1.5T Intera CV). A 3-slice short axis SSFP perfusion scan with a saturation prepulse was performed during infusion of adenosine and at rest followed by myocardial scar (late enhancement) imaging. Gadolinium-DTPA was given at 0.1mmol/kg body weight. Perfusion images were visually assessed. Analysis regarding myocardial hypoperfusion was done per patient and per vessel.
Results: Sensitivity, specificity and accuracy of MRI first-pass perfusion for detection of a coronary artery stenosis (>50% luminal narrowing) on a per patient basis was 93.0%, 85.7%, 91.2% and for a significant lesion (>70% luminal narrowing) 96.1%, 72.0%, 88.2%, respectively. Based on 536 coronary artery territories without myocardial scar, the sensitivity of MRI perfusion analysis for detection of a significant lesion was for the LAD 91.4%, CX 81.6% and RCA 65.1% (p<0.001).
Conclusions: MRI fist-pass perfusion analysis using a SSFP sequence with three myocardial slices provides a high diagnostic impact regarding detection of coronary artery stenoses. This MRI technique can be included into daily practice with the potential to guide the indication for invasive coronary angiography.
- coronary angiography
- coronary stenosis
- magnetic resonance imaging
- myocardial perfusion
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