Detection of myocardial ischemia: Value of combined myocardial perfusion and cineangiographic MR imaging

G. Hartnell, A. Cerel, Masoor Kamalesh, J. P. Finn, T. Hill, M. Cohen, R. Tello, S. Lewis

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

OBJECTIVE. Established noninvasive methods for assessing myocardial ischemia have limitations that might be overcome by MR imaging. We investigated MR myocardial perfusion imaging and MR ventriculography, before and after dipyridamole-induced stress, to determine whether the superior spatial and temporal resolution of MR imaging has advantages for the evaluation of myocardial ischemia. SUBJECTS AND METHODS. Eighteen patients with symptoms suggestive of myocardial ischemia were examined by use of MR perfusion imaging and MR cineangiography before and during dipyridamole- induced stress. Multiplanar gradient-echo MR cineangiography and cardiac gated fast low-angle shot (turbo-FLASH) MR imaging during injection of gadopentetate dimeglumine were used. Results were compared with findings from perfusion scintigraphy and coronary arteriography. RESULTS. The accuracy of the combination MR technique for detecting myocardial ischemia was similar to that of scintigraphy. No significant difference was found between the MR technique and scintigraphy for detecting segments of myocardium supplied by stenosed coronary arteries (>70% reduction in diameter, as determined by coronary arteriography). The sensitivity of the combination MR technique for angiographically detecting significant coronary artery narrowing was 92%, and the specificity was 100%. For scintigraphy, the sensitivity was also 92% and the specificity was 100%. CONCLUSION. Initial results indicate that a combination of stress MR myocardial perfusion imaging and MR ventriculography is feasible and that this technique can detect myocardial ischemia with an accuracy similar to that of scintigraphy. This technique may make more complete noninvasive assessment of myocardial ischemia possible.

Original languageEnglish (US)
Pages (from-to)1061-1067
Number of pages7
JournalAmerican Journal of Roentgenology
Volume163
Issue number5
StatePublished - 1994
Externally publishedYes

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Myocardial Ischemia
Perfusion
Radionuclide Imaging
Cineangiography
Myocardial Perfusion Imaging
Perfusion Imaging
Dipyridamole
Coronary Vessels
Angiography
Gadolinium DTPA
Myocardium
Injections

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Hartnell, G., Cerel, A., Kamalesh, M., Finn, J. P., Hill, T., Cohen, M., ... Lewis, S. (1994). Detection of myocardial ischemia: Value of combined myocardial perfusion and cineangiographic MR imaging. American Journal of Roentgenology, 163(5), 1061-1067.

Detection of myocardial ischemia : Value of combined myocardial perfusion and cineangiographic MR imaging. / Hartnell, G.; Cerel, A.; Kamalesh, Masoor; Finn, J. P.; Hill, T.; Cohen, M.; Tello, R.; Lewis, S.

In: American Journal of Roentgenology, Vol. 163, No. 5, 1994, p. 1061-1067.

Research output: Contribution to journalArticle

Hartnell, G, Cerel, A, Kamalesh, M, Finn, JP, Hill, T, Cohen, M, Tello, R & Lewis, S 1994, 'Detection of myocardial ischemia: Value of combined myocardial perfusion and cineangiographic MR imaging', American Journal of Roentgenology, vol. 163, no. 5, pp. 1061-1067.
Hartnell, G. ; Cerel, A. ; Kamalesh, Masoor ; Finn, J. P. ; Hill, T. ; Cohen, M. ; Tello, R. ; Lewis, S. / Detection of myocardial ischemia : Value of combined myocardial perfusion and cineangiographic MR imaging. In: American Journal of Roentgenology. 1994 ; Vol. 163, No. 5. pp. 1061-1067.
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AU - Hartnell, G.

AU - Cerel, A.

AU - Kamalesh, Masoor

AU - Finn, J. P.

AU - Hill, T.

AU - Cohen, M.

AU - Tello, R.

AU - Lewis, S.

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N2 - OBJECTIVE. Established noninvasive methods for assessing myocardial ischemia have limitations that might be overcome by MR imaging. We investigated MR myocardial perfusion imaging and MR ventriculography, before and after dipyridamole-induced stress, to determine whether the superior spatial and temporal resolution of MR imaging has advantages for the evaluation of myocardial ischemia. SUBJECTS AND METHODS. Eighteen patients with symptoms suggestive of myocardial ischemia were examined by use of MR perfusion imaging and MR cineangiography before and during dipyridamole- induced stress. Multiplanar gradient-echo MR cineangiography and cardiac gated fast low-angle shot (turbo-FLASH) MR imaging during injection of gadopentetate dimeglumine were used. Results were compared with findings from perfusion scintigraphy and coronary arteriography. RESULTS. The accuracy of the combination MR technique for detecting myocardial ischemia was similar to that of scintigraphy. No significant difference was found between the MR technique and scintigraphy for detecting segments of myocardium supplied by stenosed coronary arteries (>70% reduction in diameter, as determined by coronary arteriography). The sensitivity of the combination MR technique for angiographically detecting significant coronary artery narrowing was 92%, and the specificity was 100%. For scintigraphy, the sensitivity was also 92% and the specificity was 100%. CONCLUSION. Initial results indicate that a combination of stress MR myocardial perfusion imaging and MR ventriculography is feasible and that this technique can detect myocardial ischemia with an accuracy similar to that of scintigraphy. This technique may make more complete noninvasive assessment of myocardial ischemia possible.

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