Published Online
on March 24, 2003

A more recent version of this article appeared on April 8, 2003

This Article Full Text (PDF) All Versions of this Article: 107/13/1738    most recent 01.CIR.0000060542.79482.81v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nagel, E. Articles by Fleck, E. Search for Related Content PubMed PubMed Citation Articles by Nagel, E. Articles by Fleck, E. Pubmed/NCBI databases Medline Plus Health Information MRI Scans Related Collections Restenosis Catheter-based coronary interventions: stents Coronary imaging: angiography/ultrasound/Doppler/CC CT and MRI

Submitted on November 13, 2002
Revised on January 16, 2003
Accepted on January 16, 2003

Noninvasive Determination of Coronary Blood Flow Velocity With Cardiovascular Magnetic Resonance in Patients After Stent Deployment

Eike Nagel MD^*, Thomas Thouet , Christoph Klein MD, Simon Schalla MD, Axel Bornstedt PhD, Bernhard Schnackenburg PhD, Jürgen Hug MD, Ernst Wellnhofer MD, and Eckart Fleck MD

From the Department of Internal Medicine/Cardiology, German Heart Institute, Berlin, and Philips Medical Systems (B.S.), Hamburg, Germany.

^* To whom correspondence should be addressed. E-mail: eike.nagel{at}dhzb.de.

Background--In patients with coronary artery stents, no direct noninvasive coronary artery imaging is possible with magnetic resonance (MR). A well-established method for the assessment of the functional significance of a coronary lesion is the measurement of coronary flow reserve by invasive intracoronary Doppler. The purpose of the study was to determine coronary flow velocity reserve (CFVR) with MR after stent deployment.

Methods and Results--Thirty-eight patients after successful PTCA and stent deployment were included. CFVR was measured perpendicular to the artery distal to the stent using phase-contrast velocity quantification at rest and during adenosine-stimulated hyperemia with a 1.5T MR tomograph (ACS NT, Philips). Measurements were repeated after 3 months and compared with invasive coronary angiography. In 18 patients, additional invasive Doppler flow measurements were obtained. CFVR could be determined in 29 of 38 (76%) of the patients. After 3 months, significant differences were obtained between coronary arteries with and without restenosis. Using a threshold of 1.2, a sensitivity of 83% with a specificity of 94% was achieved for 75% stenoses. CFVR with CMR was similar to Doppler results (r=0.87), with a mean relative difference of 7.5%.

Conclusions--In patients with preserved coronary microcirculating vasoreactivity that are suitable for MR coronary angiography and flow assessments, CMR measures of coronary blood flow velocities reserve may be used to detect in-stent restenosis.

Key words: magnetic resonance imaging • coronary disease • angiography • restenosis

This article has been cited by other articles:

				P. G. Camici and O. E. Rimoldi The Clinical Value of Myocardial Blood Flow Measurement J. Nucl. Med., July 1, 2009; 50(7): 1076 - 1087. [Abstract] [Full Text] [PDF]

				D. A. Bluemke, S. Achenbach, M. Budoff, T. C. Gerber, B. Gersh, L. D. Hillis, W. G. Hundley, W. J. Manning, B. F. Printz, M. Stuber, et al. Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young Circulation, July 29, 2008; 118(5): 586 - 606. [Full Text] [PDF]

				E. Spuentrup, A. Ruebben, A. Mahnken, M. Stuber, C. Kolker, T. H. Nguyen, R. W. Gunther, and A. Buecker Artifact-Free Coronary Magnetic Resonance Angiography and Coronary Vessel Wall Imaging in the Presence of a New, Metallic, Coronary Magnetic Resonance Imaging Stent Circulation, March 1, 2005; 111(8): 1019 - 1026. [Abstract] [Full Text] [PDF]

				M. Terashima, C. H. Meyer, B. G. Keeffe, E. J. Putz, E. de la Pena-Almaguer, P. C. Yang, B. S. Hu, D. G. Nishimura, and M. V. McConnell Noninvasive assessment of coronary vasodilation using magnetic resonance angiography J. Am. Coll. Cardiol., January 4, 2005; 45(1): 104 - 110. [Abstract] [Full Text] [PDF]

				P. R. Moreno and V. Fuster The year in atherothrombosis J. Am. Coll. Cardiol., December 7, 2004; 44(11): 2099 - 2110. [Full Text] [PDF]

				L. P. Salm, J. J. Bax, H. W. Vliegen, S. E. Langerak, P. Dibbets, J. W. Jukema, H. J. Lamb, E. K.J. Pauwels, A. de Roos, and E. E. van der Wall Functional significance of stenoses in coronary artery bypass grafts: Evaluation by single-photon emission computed tomography perfusion imaging, cardiovascular magnetic resonance, and angiography J. Am. Coll. Cardiol., November 2, 2004; 44(9): 1877 - 1882. [Abstract] [Full Text] [PDF]

				D. J. Pennell, U. P. Sechtem, C. B. Higgins, W. J. Manning, G. M. Pohost, F. E. Rademakers, A. C. van Rossum, L. J. Shaw, and E. K. Yucel Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report Eur. Heart J., November 1, 2004; 25(21): 1940 - 1965. [Full Text] [PDF]