BioMed Central Page 1 of 1 (page number not for citation purposes) Journal of Cardiovascular Magnetic Resonance Open Access Poster presentation Adenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 T is not inferior to 1.5 T Peter Bernhardt*, Jochen Spieß, Robert Gradinger and Vinzenz Hombach Address: University of Ulm, Ulm, Germany * Corresponding author Introduction Adenosine-stress magnetic resonance imaging (CMR) at 1.5 T has established for diagnosis of inducible myocardial ischemia in patients with suspected coronary artery disease (CAD). However, little is known about feasibility and accuracy of stress-perfusion performed at 3 T. Purpose Aim of our study was to compare 1.5 T and 3 T stress perfusion for diagnosis of inducible myocardial ischemia representative for coronary artery stenosis in patients with suspected coronary artery disease. Methods Patients with clinical indication for coronary x-ray angiography underwent previously adenosine-stress CMR at 1.5 T (Intera, Philips Medical Systems) and 3 T (Achieva, Philips Medical Systems) within 48 hours. Within 72 hours after the last CMR examination coronary angiography was performed in these patients. A SSFP-based sequence was used for perfusion imaging at 1.5 T and a gradient-echo sequence at 3 T. Three short axis distributed along the left ventricle were acquired, consequently after three minutes of adenosine infusion at a constant rate (140 μg/kg/min) to visualize myocardial first-pass of 0.075 mmol/kg Gadolinium-based contrast agent (Dotarem, Guerbet). Ten minutes later the same perfusion sequence using a second contrast bolus was performed during rest. All CMR images were analyzed by two blinded and experienced readers in consensus for pres- ence of hypoperfusion during stress perfusion. Perfusion sequences were evaluated using the 17-segment-model. A relevant stenosis was defined by QCA as luminal reduc- tion ≥70% in a vessel with ≥2 mm diameter. Results 123 perfusion territories of LAD, RCX and RCA were analyzed. 11 territories were excluded due to poor image quality in one of the examination at either magnetic field strength. In 45 coronary arteries stenoses ≥70% were found by coronary x-ray angiography. 1.5 T CMR stress perfusion yielded a sensitivity of 0.89, a specificity of 0.93 and an overall accuracy of 0.91 for the diagnosis of coronary artery stenosis. Sensitivity of 3 T CMR stress perfusion was 0.91, sensitivity 0.90 and overall accuracy 0.90. Conclusion Adenosine-stress CMR perfusion using a gradient-echo sequence at 3 T is feasible for diagnosis of coronary artery stenosis and is not inferior to the established 1.5 T CMR stress perfusion. Further studies are warranted to evaluate whether 3 T stress perfusion could be also used for quan- titative perfusion analysis and may even be superior to 1.5 T examination. from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P215 doi:10.1186/1532-429X-12-S1-P215 <supplement> <title> Abstracts of the 13th Annual SCMR Scientific Sessions - 2010 </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement> This abstract is available from: http://jcmr-online.com/content/12/S1/P215 © 2010 Bernhardt et al; licensee BioMed Central Ltd.

Adenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 T is not inferior to 1.5 T

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Page 1: Adenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 T is not inferior to 1.5 T

BioMed Central

Page 1 of 1(page number not for citation purposes)

Journal of Cardiovascular Magnetic Resonance

Open AccessPoster presentationAdenosine-stress magnetic resonance perfusion for detection of coronary artery stenosis at 3 T is not inferior to 1.5 TPeter Bernhardt*, Jochen Spieß, Robert Gradinger and Vinzenz Hombach

Address: University of Ulm, Ulm, Germany

* Corresponding author

IntroductionAdenosine-stress magnetic resonance imaging (CMR) at1.5 T has established for diagnosis of inducible myocar-dial ischemia in patients with suspected coronary arterydisease (CAD). However, little is known about feasibilityand accuracy of stress-perfusion performed at 3 T.

PurposeAim of our study was to compare 1.5 T and 3 T stress per-fusion for diagnosis of inducible myocardial ischemiarepresentative for coronary artery stenosis in patients withsuspected coronary artery disease.

MethodsPatients with clinical indication for coronary x-ray angiog-raphy underwent previously adenosine-stress CMR at 1.5T (Intera, Philips Medical Systems) and 3 T (Achieva,Philips Medical Systems) within 48 hours. Within 72hours after the last CMR examination coronary angiogra-phy was performed in these patients. A SSFP-basedsequence was used for perfusion imaging at 1.5 T and agradient-echo sequence at 3 T. Three short axis distributedalong the left ventricle were acquired, consequently afterthree minutes of adenosine infusion at a constant rate(140 µg/kg/min) to visualize myocardial first-pass of0.075 mmol/kg Gadolinium-based contrast agent(Dotarem, Guerbet). Ten minutes later the same per-fusion sequence using a second contrast bolus was per-formed during rest. All CMR images were analyzed by twoblinded and experienced readers in consensus for pres-ence of hypoperfusion during stress perfusion. Perfusionsequences were evaluated using the 17-segment-model. A

relevant stenosis was defined by QCA as luminal reduc-tion ≥70% in a vessel with ≥2 mm diameter.

Results123 perfusion territories of LAD, RCX and RCA were ana-lyzed. 11 territories were excluded due to poor imagequality in one of the examination at either magnetic fieldstrength. In 45 coronary arteries stenoses ≥70% werefound by coronary x-ray angiography. 1.5 T CMR stressperfusion yielded a sensitivity of 0.89, a specificity of 0.93and an overall accuracy of 0.91 for the diagnosis of coro-nary artery stenosis. Sensitivity of 3 T CMR stress per-fusion was 0.91, sensitivity 0.90 and overall accuracy0.90.

ConclusionAdenosine-stress CMR perfusion using a gradient-echosequence at 3 T is feasible for diagnosis of coronary arterystenosis and is not inferior to the established 1.5 T CMRstress perfusion. Further studies are warranted to evaluatewhether 3 T stress perfusion could be also used for quan-titative perfusion analysis and may even be superior to 1.5T examination.

from 13th Annual SCMR Scientific SessionsPhoenix, AZ, USA. 21-24 January 2010

Published: 21 January 2010

Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P215 doi:10.1186/1532-429X-12-S1-P215

<supplement> <title> Abstracts of the 13th Annual SCMR Scientific Sessions - 2010 </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement>

This abstract is available from: http://jcmr-online.com/content/12/S1/P215

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