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Updated: Aug 16, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Detection of regional myocardial perfusion deficit using rest and stress perfusion MRI: a feasibility study
Michael Fenchel1, Uwe Helber, Ulrich Kramer
1Department of Diagnostic Radiology, Eberhard-Karls-University, Tuebingen 72076, Germany.
Objective:
Providing high temporal and spatial resolution, perfusion MRI is an attractive alternative to traditional radionuclide methods like SPECT and PET. Although first-pass perfusion MRI examinations have gained increasing attention during the past years, this technique still exhibits relatively low signal-to-noise ratio and cardiac coverage. Previous studies have suggested that refocused gradient sequence technology (e.g., true fast imaging with steady-state precession [FISP]) should improve perfusion MRI examinations. The aim of this study was to assess myocardial perfusion deficits in patients with proven coronary artery disease using a saturation recovery true FISP perfusion sequence.
Subjects And Methods:
Rest and stress perfusion MRI studies were performed in 22 patients with coronary artery disease at 1.5 T using a multislice saturation recovery true FISP sequence after the bolus injection of 0.025 mmol/kg of body weight of gadopentetate dimeglumine. The myocardium of each slice was divided into 12 radial segments with subdivision into subendocardial and subepicardial subregions. Myocardial perfusion was assessed semiquantitatively and independently for each subregion. The standard of reference for myocardial perfusion was SPECT. Delayed enhancement images were acquired after the injection of 0.15 mmol/kg of body weight of gadopentetate dimeglumine.
Results:
Sensitivity and specificity of perfusion MRI examinations for the detection of perfusion deficits were 81% and 89%, respectively, for the semiquantitative perfusion parameter upslope and 78% and 86% for the parameter peak signal intensity. More specifically, rest perfusion examinations were able to detect areas of infarction, whereas stress examinations increased the perfusion differences between normal and ischemic myocardial areas. Excellent correlation was observed between rest perfusion and late enhancement findings (r = 0.90).
Conclusion:
In patients with single-vessel coronary artery disease, perfusion deficits can reliably be detected using a saturation recovery true FISP sequence. Semiquantitative perfusion parameters upslope and peak signal intensity yielded similar results.
Insights
Saturation recovery true FISP perfusion MRI reliably detects myocardial perfusion deficits in coronary artery disease patients. This technique offers an alternative to SPECT, with good sensitivity and specificity for identifying perfusion abnormalities.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
- Myocardial Perfusion Assessment
Background:
- Perfusion MRI offers high temporal and spatial resolution, serving as an alternative to radionuclide imaging like SPECT and PET.
- Traditional first-pass perfusion MRI has limitations in signal-to-noise ratio and cardiac coverage.
- True fast imaging with steady-state precession (FISP) sequences may enhance perfusion MRI examinations.
Purpose of the Study:
- To evaluate myocardial perfusion deficits in patients with coronary artery disease (CAD) using a saturation recovery true FISP perfusion sequence.
- To assess the diagnostic performance of this novel MRI technique compared to SPECT.
Main Methods:
- 22 patients with CAD underwent rest and stress perfusion MRI at 1.5 T using a saturation recovery true FISP sequence.
- Gadolinium contrast agent was administered, and myocardial segments were analyzed semiquantitatively.
- SPECT served as the reference standard for myocardial perfusion.
Main Results:
- The saturation recovery true FISP sequence demonstrated high sensitivity (81%) and specificity (89%) for detecting perfusion deficits using the upslope parameter.
- Rest perfusion MRI identified areas of infarction, while stress MRI enhanced the detection of perfusion differences between normal and ischemic regions.
- Excellent correlation (r=0.90) was found between rest perfusion MRI and late enhancement findings.
Conclusions:
- Saturation recovery true FISP perfusion MRI reliably detects perfusion deficits in patients with single-vessel coronary artery disease.
- Semiquantitative parameters like upslope and peak signal intensity provide comparable diagnostic results.
