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Updated: Jun 4, 2026
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
High spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance
Insights
High-resolution Dobutamine Stress Magnetic Resonance (DSMR) perfusion imaging accurately detects coronary artery disease (CAD) and its extent. This advanced technique improves diagnostic sensitivity compared to standard DSMR-wall motion analysis.
Area of Science:
- Cardiovascular Imaging
- Magnetic Resonance Imaging
- Coronary Artery Disease Diagnostics
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate imaging techniques.
- Dobutamine Stress Magnetic Resonance (DSMR) is a valuable tool for CAD assessment.
- Improving spatial resolution in DSMR can enhance diagnostic capabilities.
Purpose of the Study:
- To evaluate the feasibility of high spatial resolution myocardial perfusion imaging using DSMR.
- To determine the diagnostic accuracy of this technique for detecting CAD.
- To assess its effectiveness in identifying the extent of coronary artery disease.
Main Methods:
- Prospective study involving 78 patients undergoing invasive coronary angiography.
- High spatial resolution (1.5 × 1.5mm²) DSMR perfusion imaging using k-t SENSE.
- Sequential interpretation of DSMR-wall motion and DSMR-perfusion data.
Main Results:
- DSMR-perfusion combined with DSMR-wall motion improved CAD detection sensitivity (92% vs. 81%, P=0.03).
- Accurate determination of disease extent was significantly enhanced (85% vs. 66% territories, P<0.001).
- Image quality was good with limited artifacts; specificity and accuracy showed no significant difference.
Conclusions:
- High spatial resolution DSMR-perfusion imaging is feasible and effective at maximum stress.
- It significantly improves sensitivity for CAD detection and disease extent assessment.
- This technique offers improved specificity compared to previous lower-resolution methods.
Purpose:
To prospectively evaluate the feasibility and diagnostic accuracy of high spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance (DSMR) for the detection of coronary artery disease (CAD).
Methods And Results:
DSMR-wall motion was combined with perfusion imaging (DSMR-perfusion) in 78 patients prior to clinically indicated invasive coronary angiography. For DSMR-perfusion an in-plane spatial resolution of 1.5 × 1.5mm(2) was attained by using 8 × k-space and time sensitivity encoding (k-t SENSE). Image quality and extent of artifacts during perfusion imaging were evaluated. Wall motion and perfusion data were interpreted sequentially. Significant CAD (stenosis ≥ 70%) was present in 52 patients and involved 86 coronary territories. One patient did not reach target heart rate despite maximum infusion of dobutamine/atropine. Two studies (3%) were non-diagnostic due k-t SENSE related artifacts resulting from insufficient breathhold capability. Overall image quality was good. Dark-rim artifacts were limited to the endocardial border at a mean width of 1.8mm. The addition of DSMR-perfusion to DSMR-wall motion data improved sensitivity for the detection of CAD (92% vs. 81%, P=0.03) and accurate determination of disease extent (85% vs. 66% of territories, P<0.001). There were no significant differences between DSMR-perfusion and DSRM-wall motion regarding overall specificity (83% vs. 87%, P=1) and accuracy (89% vs. 83%, P=0.13).
Conclusion:
High spatial resolution DSMR-perfusion imaging at maximum stress level was feasible, improved sensitivity over DSMR-wall motion for the detection of CAD and allowed an accurate determination of disease extent. Specificity of DSMR-perfusion with k-t SENSE improved compared to prior studies using lower spatial resolution.
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