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European Heart Journal Advance Access originally published online on July 18, 2008
European Heart Journal 2008 29(17):2148-2155; doi:10.1093/eurheartj/ehn297
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

High spatial resolution myocardial perfusion cardiac magnetic resonance for the detection of coronary artery disease

Sven Plein1,2,*, Sebastian Kozerke1, Daniel Suerder3, Thomas F. Luescher3, John P. Greenwood2, Peter Boesiger1 and Juerg Schwitter3

1 Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
2 Academic Unit of Cardiovascular Medicine, University of Leeds, G-Floor Jubilee Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
3 Cardiovascular Centre, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland

Received 28 January 2008; revised 5 June 2008; accepted 11 June 2008; online publish-ahead-of-print 18 July 2008.

* Corresponding author. Tel: +44 113 392 5404, Fax: +44 113 392 5405, Email: s.plein{at}leeds.ac.uk

Aims: To evaluate the feasibility and diagnostic performance of high spatial resolution myocardial perfusion cardiac magnetic resonance (perfusion-CMR).

Methods and results: Fifty-four patients underwent adenosine stress perfusion-CMR. An in-plane spatial resolution of 1.4 x 1.4 mm2 was achieved by using 5x k-space and time sensitivity encoding (k–t SENSE). Perfusion was visually graded for 16 left ventricular and two right ventricular (RV) segments on a scale from 0 = normal to 3 = abnormal, yielding a perfusion score of 0–54. Diagnostic accuracy of the perfusion score to detect coronary artery stenosis of >50% on quantitative coronary angiography was determined. Sources and extent of image artefacts were documented.

Two studies (4%) were non-diagnostic because of k–t SENSE-related and breathing artefacts. Endocardial dark rim artefacts if present were small (average width 1.6 mm). Analysis by receiver–operating characteristics yielded an area under the curve for detection of coronary stenosis of 0.85 [95% confidence interval (CI) 0.75–0.95] for all patients and 0.82 (95% CI 0.65–0.94) and 0.87 (95% CI 0.75–0.99) for patients with single and multi-vessel disease, respectively. Seventy-four of 102 (72%) RV segments could be analysed.

Conclusion: High spatial resolution perfusion-CMR is feasible in a clinical population, yields high accuracy to detect single and multi-vessel coronary artery disease, minimizes artefacts and may permit the assessment of RV perfusion.

Key Words: Magnetic resonance imaging • Myocardial perfusion • Ischaemia • Coronary artery disease


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