NONINVASIVE STRESS-TESTING OF MYOCARDIAL-ISCHEMIA - COMPARISON OF GRE-MRI PERFUSION AND WALL-MOTION ANALYSIS TO TC-99M-MIBI-SPECT, RELATIONTO CORONARY ANGIOGRAPHY

In the evaluation of ischemic heart disease only MR imaging seems to h ave the potential to assess myocardial perfusion, function, and corona ry morphology on a single instrument. The aim of this study was to ass ess the feasibility of a stress test with dipyridamole (0.56 mg/kg) to analyze myocardial perfusion by Gd first-pass enhancement in ultrafas t gradient-recall-echo MRI (perf-MRI), and wall motion by cine gradien t-recall-echo MRI (Cine-MRI) in one imaging session. Twelve patients u nderwent complete rest and stress studies; satisfactory MR images were acquired in 10 patients. By Tc-99m-MIBI-SPECT sensitivities to detect ischemic segments were 66.7% with Perf-MRI, 80.0% with WM-MRI and 86. 7% for Perf-WM-MRI (Perf-MRI vs Perf-WM-MRI; p = 0.03). Scar was equal ly detected with a sensitivity of 91.6% with either MRI technique. Thu s, Perf-Cine-MRI provides complementary information for the management of ischemic heart disease and has a higher sensitivity than Perf-MRI alone.