Magnetic resonance imaging of regional myocardial perfusion in patients with single-vessel coronary artery disease: quantitative comparison with (201)Thallium-SPECT and coronary angiography

• Published in: Journal of magnetic resonance imaging 2000-06, Vol.11 (6), p.607-615
• Main Authors: Keijer, J T, van Rossum, A C, van Eenige, M J, Bax, J J, Visser, F C, Teule, J J, Visser, C A
• Format: Article
• Language: English
• Subjects: Aged; Coronary Angiography - methods; Coronary Disease - diagnosis; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Female; Humans; Linear Models; Magnetic Resonance Imaging - methods; Male; Middle Aged; Myocardium - pathology; Sensitivity and Specificity; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon - methods
• ISSN: 1053-1807
• DOI: 10.1002/1522-2586(200006)11:6<607::AID-JMRI6>3.0.CO;2-7

The clinical value of magnetic resonance perfusion imaging (MRI) was investigated by quantitative comparison with (201)thallium-single-photon emission computed tomography ((201)TI-SPECT) and quantitative coronary angiography (QCA). Short-axis imaging was performed during dipyridamole administration in 13 patients with single-vessel coronary artery disease. Using inner and outer contours, the myocardium was divided into 30 contiguous, radial regions. Defining a perfusion defect as a region with less than 90% of maximum (201)TI intensity, nine patients had a matching perfusion defect, two had no defect on both (201)TI-SPECT or MRI, and one had a defect on (201)TI-SPECT but not on MRI. One patient had a defect on both modalities but with inaccurate localization. Three perfusion parameters were investigated: a) maximum contrast enhancement (MCE); b) slope of the signal intensity versus time curve; and c) inverse mean transit time (1/MTT). The sensitivity and specificity of MCE in the detection of perfusion abnormalities with TI-SPECT as the reference method were 71% and 71%, respectively (slope 77% and 61%, 1/MTT 44% and 70%). Furthermore, correlations were calculated per patient for the entire circumference of the short-axis myocardium. Median correlations were as follows: MCE 0.92, slope 0.91, and 1/MTT 0.40. Mismatches between (201)TI defects and defects on MRI resulted in low mean correlations (MCE 0.45, slope 0.46, and 1/MTT 0.26). There was a trend between severity of perfusion defects on MRI (using MCE) and QCA stenosis area (r = -0.56, P = 0.06). Thus, MRI and (201)TI-SPECT demonstrate fair agreement in the assessment of perfusion defects but show moderate correlation when the entire short-axis myocardium is correlated.