Evaluation of ischemic heart disease on a 1.5 Tesla scanner: combined first-pass perfusion and viability study

We implemented a fast gradient echo (GRE) sequence with an echo-planar imaging (EPI) read-out (FGRE-ET) to conduct myocardial perfusion studies on a conventional scanner. The accuracy of combined perfusion and viability studies is evaluated in comparison with coronary angiography (CAG).

We enrolled 33 patients suspected of having coronary artery disease in this study. Short-axis perfusion images of the left ventricles were acquired following intravenous bolus injection of gadolinium-DTPA (0.05 mml/kg), both after myocardial loading by dipyridamole (0.56 mg/kg) and at rest. Viability studies were obtained using an inversion-recovery FGRE sequence. Radiologists performed blinded film readings. The findings with perfusion and the viability studies were compared with CAG on a segment-to-segment basis corresponding to the coronary arteries' territories. Stenosis equal to or greater than 75% in diameter was considered significant on CAG. The results were also compared with single photon emission computed tomography (SPECT) in 23 patients.

The combination of perfusion and viability studies showed 85.7% sensitivity, 88.9% specificity, and 87.2% accuracy in comparison with CAG. SPECT revealed respective rates of 71.7%, 78.3%, and 73.9% in 23 patients of this group.

Myocardial perfusion studies using FGRE-ET were feasible and accurate, even on a conventional scanner.