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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Perfusion impairment in patients with normal-appearing coronary arteries: identification with contrast-enhanced MR

Luíz Francisco Rodrigues de Avila1, Juliano Lara Fernandes, Carlos Eduardo Rochitte

  • 1Cardiovascular Magnetic Resonance Laboratory Heart Institute and Institute of Radiology, University of São Paulo Medical School, Coord Diagnostico por Imagem, Av Dr Enéas de Carvalho Aguiar 44, São Paulo, SP 05403-000, Brazil.

Radiology
|December 24, 2005
PubMed

Insights

First-pass magnetic resonance (MR) imaging effectively differentiates myocardial segments based on coronary artery disease (CAD) severity. This technique aids in identifying impaired perfusion in patients with CAD, even with normal-appearing arteries.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Medical Diagnostics

Background:

  • Coronary artery disease (CAD) diagnosis relies on assessing myocardial perfusion.
  • Non-invasive imaging techniques are crucial for evaluating CAD severity and impact.

Purpose of the Study:

  • To assess the feasibility of first-pass contrast-enhanced magnetic resonance (MR) imaging.
  • To differentiate myocardial segments in patients with varying degrees of obstructive CAD and normal coronary arteries.

Main Methods:

  • Prospective study involving 37 patients with suspected or confirmed CAD.
  • First-pass MR imaging performed at rest and during pharmacologic stress (dipyridamole).
  • Analysis of signal intensity upslope, peak signal intensity, and time to peak signal intensity, including hyperemia-to-rest ratios.

Main Results:

  • Signal intensity upslope was significantly higher in patients with normal coronary arteries compared to those with CAD (P < .001).
  • Signal intensity upslope and peak signal intensity differentiated segments with >70% luminal diameter reduction (P < .05, P < .01).
  • Hyperemia-to-rest ratios corroborated findings from individual signal intensity variables.

Conclusions:

  • First-pass MR imaging is feasible for distinguishing myocardial segments with varying obstructive CAD.
  • MR imaging can identify impaired perfusion in CAD patients, including those with normal-appearing coronary arteries.
  • The technique can demonstrate obstructive lesions in different coronary territories.
Abstract

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