Blood oxygen level-dependent magnetic resonance imaging in patients with stress-induced angina

• Published in: Circulation (New York, N.Y.) N.Y.), 2003-11, Vol.108 (18), p.2219-2223
• Main Authors: FRIEDRICH, Matthias G, NIENDORF, Thoralf, SCHULZ-MENGER, Jeanette, GROSS, C. Michael, DIETZ, Rainer
• Format: Article
• Language: English
• Subjects: Adenosine; Angina Pectoris - blood; Angina Pectoris - diagnosis; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Coronary Angiography; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Exercise Test; Feasibility Studies; Humans; Magnetic Resonance Imaging - methods; Medical sciences; Oxygen - blood; Predictive Value of Tests; ROC Curve; Sensitivity and Specificity; Stress, Physiological; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.0000095271.08248.EA

Blood oxygen level-dependent (BOLD) MRI reflects tissue oxygenation and may be useful for the detection of myocardial ischemia in patients with suspected coronary artery disease. We studied 25 patients with stress-induced angina using a T2*-sensitive echo planar imaging sequence before and during adenosine in a single-slice approach. BOLD-MRI results were compared with quantitative angiography and adenosine thallium single-photon emission computed tomography (SPECT). Although image quality was variable because of artifacts, no data were excluded from the analysis. During adenosine, a mean signal intensity decrease was observed for myocardial segments related to coronary stenoses >75%. On average, a nonsignificant increase was observed in the other segments. The angiographically determined stenosis was correlated with BOLD-MRI results. Including all segments and using BOLD-MRI signal intensity increase cutoff value of 1.2%, BOLD-MRI had a sensitivity of 88% and a specificity of 47% to correctly classify severe stenoses. Adenosine thallium SPECT data from distal segments of the same coronary territory were also correlated with BOLD-MRI. However, variability was substantial. In patients with stress-induced angina, adenosine BOLD-MRI detects myocardial ischemia in myocardial segments related to severe coronary stenoses. Its potential will increase with additional improvement of spatial coverage and image quality.