MULTISLICE MRI IN ASSESSMENT OF MYOCARDIAL PERFUSION IN PATIENTS WITHSINGLE-VESSEL PROXIMAL LEFT ANTERIOR DESCENDING CORONARY-ARTERY DISEASE BEFORE AND AFTER REVASCULARIZATION

Background Our purpose was to use multislice MRI for detection of reve rsible myocardial ischemia and assessment of the effect of revasculari zation on tissue perfusion in patients with coronary artery disease. M ethods and Results Eleven patients with single-vessel proximal left an terior descending coronary artery disease were studied with MRI and th allium scintigraphy before and 3 months after revascularization. All p atients had a reversible perfusion defect by scintigraphy before treat ment. With a 1.5-T MR imager, IR-prepared turboflash images were acqui red in three left ventricular short-axis planes during 0.05 mmol/kg Gd -DTPA bolus at rest and with dipyridamole-induced stress. Before treat ment, stress increased enhancement slope in normal (6.4+/-4.4 to 7.4+/ -5.0 s(-1), P<.04) and decreased it in underperfused (5.4+/-3.7 to 2.6 +/-1.4 s(-1), P<.02) regions, resulting in a contrast-to-noise ratio o f 6.87+/-3.09 in underperfused myocardium. Revascularization normalize d enhancement patterns of the formerly underperfused myocardium and de creased defect size both in scintigraphy (66+/-53 degrees to 8+/-12 de grees, P<.001) and MRI sections (49+/-41 degrees to 9+/-8 degrees, P<. 001). Agree ment of 85% in detection and correlation of 0.86 (SEE, 21 degrees, P<.001) in sizing perfusion defects was found between MRI and scintigraphy. Conclusions Multislice contrast-enhanced MRI can be use d to detect myocardial perfusion defects in patients with coronary art ery disease and in assessment of the effect of treatment on myocardial perfusion.