Detection of coronary artery disease by magnetic resonance myocardial perfusion imaging with various contrast medium doses: first european multi-centre experience

• DOI: 10.1016/j.ehj.2004.06.037
• Publication Date: 2004-08-27T14:36:45Z
• Authors: T GIANG; D NANZ; R COULDEN; M FRIEDRICH; M GRAVES; N ALSAADI; T LUSCHER; G VONSCHULTHESS; J SCHWITTER
• Keywords: Hyperaemia

Magnetic resonance (MR) first-pass myocardial perfusion imaging during hyperaemia detects coronary artery stenoses in humans with test sensitivity depending on contrast medium (CM)-induced signal change myocardium. In this prospective multi-centre study, the effect of CM dose and diagnostic performance was evaluated using a stress-only approach.Ninety-four patients known or suspected disease (CAD) were randomised to 0.05,0.10, 0.15 mmol/kg body weight an extravascular (Gd-DTPA) X-ray angiography performed within 30 days prior/after MR examination. A multi-slice technique identical hardware software all centres used (adenosine 0.14 mg/kg/min) monitor wash-in kinetics data analysed semi-automatically core laboratory. Protocol violations resulted 80 complete studies CAD (defined as > =1 vessel diameter stenosis =50% quantitative angiography) present 19/29, 13/24, 20/27 for doses 1, 2, 3, respectively. normal myocardium, upslope increased (overall-p<0.0001, ANOVA). For detection area under receiver operator characteristics curve subendocardial (3 slices quality score<4 representing 86% cases) 0.91+/-0.07 0.86+/-0.08 2 respectively, lower 1 (0.53+/-0.13, p<0.01 p<0.02 vs. respectively). Corresponding sensitivities/specificities (95% confidence intervals) pooled 2/3 93% (77-99%; ns 1) 75% (48-92%;p<0.05 1), respectively.With increasing CM, higher response myocardium achieved consequently protocol, 0.10-0.15 combined semi-automatic analysis, yielded high CAD.