Jr. Panting et al., Echo-planar magnetic resonance myocardial perfusion imaging: Parametric map analysis and comparison with thallium SPECT, J MAGN R I, 13(2), 2001, pp. 192-200
Magnetic resonance (MR) perfusion FLASH imaging has been used for assessing
coronary artery disease (CAD). Echo-planar MR techniques have advantages i
n speed and in making MR perfusion imaging results more clinically accessib
le through parametric maps, but have not been previously assessed. We imple
mented a spin-echo, echo-planar MR technique and applied it at rest and dur
ing adenosine stress in 26 patients with CAD and abnormal thallium single-p
hoton-emission computed tomography (SPECT), and analyzed the results by usi
ng a newly developed parametric map analysis of time to peak, peak intensit
y, and slope of contrast washin. The results were compared with the results
of conventional visual analysis of the perfusion cine series. For detectin
g abnormal coronary territories, MR and SPECT were comparable for sensitivi
ty, specificity, and accuracy (thallium, 70%, 78%, and 73%; MR, 79% 83%, an
d 80%; P = NS). There was good agreement between thallium and MR during str
ess (kappa = 0.49), but defects were larger by MR (2.4 vs. 3.1 segments for
slope; P < 0.01). Additional segments were detected at rest by MR (58 for
slope vs. 25 for thallium), which correlated with areas that became abnorma
l with stress in the thallium (sensitivity, 100%; specificity, 63%). The pa
rametric maps were easier and faster to interpret than review of the origin
al first-pass series of images (chi (2) = 10.8; P < 0.04). The diagnostic p
erformance of echo-planar perfusion MR and SPECT was similar, and combining
the results with parametric mapping was useful for interpretation and cons
iderably improved data display for clinical interpretation. MR, however, wa
s faster and yielded images of higher resolution with no radiation burden.
In multislice mode, these new MR techniques may have clinical value. (C) 20
01 Wiley-Liss, Inc.