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Updated: Jul 16, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

The delay of contrast arrival in magnetic resonance first-pass perfusion imaging: a novel non-invasive parameter

O M Muehling1, A Huber, C Cyran

  • 1Department of Medicine and Radiology, University of Munich, Munich, Germany. olaf.muehling@med.uni-muenchen.de

Heart (British Cardiac Society)
|March 9, 2007
PubMed

Insights

Magnetic resonance perfusion imaging (MRPI) can detect collateral-dependent myocardium in coronary artery disease by measuring the delay in contrast arrival. Hyperaemic delay time (Deltat(d)) is a sensitive and specific indicator for this condition.

Area of Science:

  • Cardiovascular Imaging
  • Medical Physics
  • Radiology

Background:

  • Coronary artery disease (CAD) can lead to collateral-dependent myocardium, impacting blood supply.
  • Accurate detection of collateral-dependent myocardium is crucial for patient management.
  • Magnetic resonance perfusion imaging (MRPI) offers a non-invasive method for assessing myocardial perfusion.

Purpose of the Study:

  • To establish the regional delay of contrast arrival using MRPI for detecting collateral-dependent myocardium in patients with CAD.
  • To compare the diagnostic accuracy of contrast arrival delay time (Deltat(d)) with myocardial perfusion (MP) measurements.

Main Methods:

  • An observational case series study involving 30 patients with CAD and collateral-dependent myocardium and 17 healthy volunteers.
  • Resting and hyperaemic (adenosine) MRPI were performed to measure Deltat(d) and MP.
  • Deltat(d) was calculated as the time difference in contrast arrival between the left ventricle and the myocardium.

Main Results:

  • Hyperaemic Deltat(d) showed high diagnostic accuracy (90% sensitivity, 83% specificity, AUC=0.89) for detecting collateral-dependent myocardium.
  • Resting Deltat(d) (AUC=0.77) and MP measurements (AUC=0.69-0.70) were less accurate compared to hyperaemic Deltat(d).
  • In patients, hyperaemic Deltat(d) was significantly longer in collateral-dependent myocardium (1.1 ± 0.6 s) versus antegradely perfused myocardium (0.4 ± 0.3 s).

Conclusions:

  • MRPI-derived hyperaemic contrast arrival delay time (Deltat(d)) is a sensitive and specific method for detecting collateral-dependent myocardium in CAD patients.
  • Deltat(d) is more effective than MP measurements for identifying areas of the myocardium dependent on collateral circulation.
  • This technique holds significant clinical value for the non-invasive assessment of collateral-dependent myocardium.
Abstract

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