Magnetic resonance imaging of regional myocardial perfusion in patients with single-vessel coronary artery disease: Quantitative comparison with (201)thallium-SPECT and coronary angiography
Jt. Keijer et al., Magnetic resonance imaging of regional myocardial perfusion in patients with single-vessel coronary artery disease: Quantitative comparison with (201)thallium-SPECT and coronary angiography, J MAGN R I, 11(6), 2000, pp. 607-615
The clinical value of magnetic resonance perfusion imaging (Mail) was inves
tigated by quantitative comparison with (201)thallium-single-photon emissio
n computed tomography (Tl-201-SPECT) and quantitative coronary angiography
(QCA). Short-axis imaging was performed during dipyridamole administration
in 13 patients with single-vessel coronary artery disease. Using inner and
outer contours, the myocardium was divided into 30 contiguous, radial regio
ns. Defining a perfusion defect as a region with less than 90% of maximum T
l-201 intensity, nine patients had a matching perfusion defect, two had no
defect on both Tl-201-SPECT or MRI, and one had a defect on Tl-201-SPECT bu
t not on NM. One patient had a defect on both modalities but with inaccurat
e localization. Three perfusion parameters were investigated: a) maximum co
ntrast enhancement (MCE); b) slope of the signal intensity versus time curv
e; and c) inverse mean transit time (1/MTT). The sensitivity and specificit
y of MCE in the detection of perfusion abnormalities with TI-SPECT as the r
eference method were 71% and 71%, respectively (slope 77% and 61%, 1/MTT 44
% and 70%). Furthermore, correlations were calculated per patient for the e
ntire circumference of the short-axis myocardium. Median correlations were
as follows: MCE 0.92, slope 0.91, and 1/MTT 0.40. Mismatches between Tl-201
defects and defects on MRI resulted in low mean correlations (MCE 0.45, sl
ope 0.46, and 1/MTT 0.26). There was a trend between severity of perfusion
defects on MRI (using MCE) and QCA stenosis area (r = -0.56, P = 0.06). Thu
s, MRI and Tl-201-SPECT demonstrate fair agreement in the assessment of per
fusion defects but show moderate correlation when the entire short-axis myo
cardium is correlated. J. Magn. Reson. Imaging 2000;11:607-615. (C) 2000 Wi
ley-Liss, Inc.