Key result
Signal intensity upslope on first-pass MR imaging was significantly higher in patients with normal coronary arteries at angiography compared to those with coronary artery disease (P < .001).
Why the study?
The feasibility of using first-pass contrast-enhanced MR imaging to distinguish myocardial segments with different degrees of coronary artery obstruction and normal-appearing coronary arteries was not established.
Cross-Sectional (n=37)
May aid noninvasive perfusion assessment in suspected CAD; leaves open diagnostic utility and outcome impact without prospective validation.
PURPOSE: To prospectively determine the feasibility of using first-pass magnetic resonance (MR) imaging to distinguish between myocardial segments in patients with coronary artery disease (CAD) of different degrees of obstruction and those in patients with normal-appearing coronary arteries. MATERIALS AND METHODS: The study was approved by the institutional ethics committee, and all patients provided informed consent. First-pass contrast material-enhanced MR imaging was performed at rest and after the infusion of dipyridamole in 37 patients (29 men, eight women; mean age, 57.2 years +/- 10.5 [standard deviation]) who had positive exercise test results or a clinical history of CAD. Myocardial segments were divided into five groups according to the degree of obstruction in the supplying artery. Signal intensity upslope, peak signal intensity, and time to peak signal intensity, as well as hyperemia-to-rest (HR) ratios for each of these three variables, were analyzed for each segment by using a generalized linear model. RESULTS: Signal intensity upslope in patients with normal coronary arteries at angiography was significantly higher than that in patients with CAD (P < .001). Signal intensity upslope for segments in patients without CAD was significantly different from that for normal-appearing segments in patients with CAD (P < .001). Signal intensity upslope (P < .05) and peak signal intensity (P < .01) enabled the differentiation of segments with more than 70% reduction in luminal diameter from those in all other groups. HR ratios demonstrated findings that were similar to those obtained by using each signal intensity variable alone. CONCLUSION: First-pass MR imaging can be used to distinguish segments with different degrees of obstructive CAD. Importantly, MR imaging can help identify segments with impaired perfusion and normal-appearing coronary arteries in patients with CAD and can demonstrate obstructive lesions in other territories.
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Ávila et al. (2006) conducted a cross-sectional in Coronary Artery Disease (n=37). Coronary artery disease vs. Normal-appearing coronary arteries was evaluated on Signal intensity upslope on first-pass MR imaging (p=<0.001). Signal intensity upslope on first-pass MR imaging was significantly higher in patients with normal coronary arteries at angiography compared to those with coronary artery disease (P < .001).
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