Quantitative myocardial perfusion in coronary artery disease: A perfusion mapping study

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Cardiac MR stress perfusion is typically qualitative due to technical challenges.
• Automated inline perfusion mapping enables on-the-fly myocardial blood flow (MBF) quantification.

Purpose of the Study:

• To evaluate the diagnostic performance of automated inline perfusion mapping for detecting obstructive coronary artery disease (CAD).
• To assess the technique's ability to detect significant coronary stenoses in patients undergoing coronary angiography.

Main Methods:

• A prospective, observational study involving 50 patients with suspected CAD and 24 healthy volunteers.
• Cardiac MR with perfusion mapping was performed, followed by invasive coronary angiography for patients.
• Analysis included receiver operator characteristic (ROC) curves for stress MBF and myocardial perfusion reserve (MPR).

Main Results:

• Patients with suspected CAD showed lower stress MBF and MPR compared to healthy volunteers.
• Decreased MBF and MPR correlated with increasing stenosis severity.
• Endocardial stress MBF demonstrated high accuracy in diagnosing obstructive CAD (>70% stenosis), with a 98% negative predictive value.

Conclusions:

• Automated inline cardiac MR perfusion mapping is a highly accurate method for diagnosing obstructive CAD.
• The technique's high sensitivity and negative predictive value position it as a valuable "rule-out" test for CAD.