Ischemic heart disease: assessment with gadolinium-enhanced ultrafast MR imaging and dipyridamole stress

The potential of magnetic resonance (MR) imaging for the detection of myocardial perfusion abnormalities in patients with coronary artery disease has not been fully explored. A feasibility study was conducted in 10 patients with a novel approach to determine whether myocardial ischemia can be assessed with MR imaging and dynamic first-pass bolus tracking enhanced with gadolinium tetraazacyclododecanetetraacetic acid (DOTA). Three tomographic planes were acquired before and after pharmacologic stress with dipyridamole, with use of the bolus-tracking series at rest as a reference. The change in myocardial rate of enhancement was compared with the results obtained by means of the established methods, exercise thallium scintigraphy and coronary angiography. Detection of ischemic regions with MR imaging showed a sensitivity, specificity, and diagnostic accuracy of 65%, 76%, and 74%, respectively. Ultrafast MR imaging can be used to detect regions of myocardial ischemia.