Detection of viable myocardium by dobutamine stress tagging magnetic resonance imaging with three-dimensional...

The present study attempted to detect the viability of myocardium by quantitative automatic 3-dimensional analysis of the improvement of regional wall motion using an magnetic resonance imaging (MRI) tagging method. Twenty-two subjects with ischemic heart disease who had abnormal wall motion on echocardiography at rest were enrolled. All patients underwent dobutamine stress echocardiography (DSE), coronary arteriography and left ventriculography. The results were compared with those of 7 normal volunteers. MRI studies were done with myocardial tagging using the spatial modulation of magnetization technique. Automatic tracing with an original program was performed, and wall motion was compared before and during dobutamine infusion. The evaluation of myocardial viability with MRI and echocardiography had similar results in 19 (86.4%) of the 22 patients; 20 were studied by positron emission tomography or thallium-201 single photon emission computed tomography for myocardial viability, or studied for improvement of wall motion following coronary intervention. The sensitivity of dobutamine stress MRI (DSMRI) with tagging was 75.9% whereas that of DSE was 65.5%. The specificity of DSMRI was 85.7% (6/7) and that of DSE was 100% (7/7). The accuracy of DSMRI was 77.8% (28/36) and that of DSE 72.2% (26/36). DSMRI was shown to be superior to DSE in terms of evaluation of myocardial viability.