Klumpp B, Hoevelborn T, Fenchel M, Stauder N I, Kramer U, May A, Gawaz M P, Claussen C D, Miller S
Eberhard-Karls-University Tübingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.
Eur J Radiol. 2009 Jan;69(1):165-72. doi: 10.1016/j.ejrad.2007.09.036. Epub 2007 Nov 19.
MR myocardial perfusion imaging (MRMPI) is an established technique for the evaluation of the hemodynamical relevance of coronary artery disease. Perfusion imaging at 3.0T provides certain advantages compared to 1.5T. Aim of this study was to evaluate myocardial MR perfusion imaging at 3.0T.
Twelve patients with stable Angina pectoris and known or suspected coronary artery disease were examined at 3.0T. Myocardial perfusion was assessed using a saturation recovery gradient echo 2D sequence (TR 1.9ms, TE 1.0ms, FA 12 degrees ) with 0.05mmol Gd-DTPA per kg body weight at stress during injection of 140microg adenosine/kg body weight/min and at rest in short axis orientation. Perfusion analysis was based on a least square fit of the signal/time curve (peak signal intensity, slope). Perfusion series were assessed by two independent observers. Reference for the presence of relevant coronary artery stenoses was invasive coronary angiography. Two experienced observers evaluated the coronary angiograms in biplane projections for the presence and grade of stenoses. Results were compared with the MR perfusion analysis.
All MR examinations could be safely performed and yielded high image quality. In eight patients stress-induced hypoperfusion was detected (stenosis >70% in coronary angiography). In four patients myocardial hypoperfusion was ruled out (stenosis <70%). The myocardial perfusion reserve index was significantly reduced in hypoperfused myocardium with 1.9+/-1.6 compared to 2.5+/-1.6 in regularly perfused myocardium (p<0.05). In coronary angiography, eight patients were found to suffer from coronary artery disease, whereas in four patients coronary artery disease was ruled out.
Our initial results show that MRMPI at 3.0T provides reliably high-image quality and diagnostic accuracy.
磁共振心肌灌注成像(MRMPI)是评估冠状动脉疾病血流动力学相关性的一项成熟技术。与1.5T相比,3.0T的灌注成像具有一定优势。本研究的目的是评估3.0T下的心肌磁共振灌注成像。
对12例患有稳定型心绞痛且已知或疑似患有冠状动脉疾病的患者进行3.0T检查。使用饱和恢复梯度回波二维序列(TR 1.9ms,TE 1.0ms,翻转角12°)评估心肌灌注,在静息状态下于短轴方向成像,在注射140μg腺苷/千克体重/分钟的负荷状态下,每千克体重使用0.05mmol钆喷酸葡胺。灌注分析基于信号/时间曲线的最小二乘拟合(峰值信号强度、斜率)。由两名独立观察者评估灌注序列。冠状动脉狭窄相关性的参考标准为有创冠状动脉造影。两名经验丰富的观察者在双平面投影中评估冠状动脉造影的狭窄情况及程度。将结果与磁共振灌注分析进行比较。
所有磁共振检查均能安全进行并获得高质量图像。8例患者检测到负荷诱导的心肌灌注不足(冠状动脉造影显示狭窄>70%)。4例患者排除心肌灌注不足(狭窄<70%)。灌注不足心肌的心肌灌注储备指数显著降低,为1.9±1.6,而正常灌注心肌为2.5±1.6(p<0.05)。在冠状动脉造影中,8例患者被发现患有冠状动脉疾病,而4例患者排除冠状动脉疾病。
我们的初步结果表明,3.0T的MRMPI能可靠地提供高质量图像和诊断准确性。