Published Online
on October 13, 2003

A more recent version of this article appeared on November 4, 2003

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Submitted on January 15, 2002
Revised on August 4, 2003
Accepted on August 13, 2003

Blood Oxygen Level-Dependent Magnetic Resonance Imaging in Patients with Stress-Induced Angina

Matthias G. Friedrich MD, FESC^*, Thoralf Niendorf PhD, Jeanette Schulz-Menger MD, C. Michael Gross MD, and Rainer Dietz MD

From Helios-Klinikum Berlin, Franz-Volhard-Klinik, Kardiologie Charité Campus Berlin-Buch, Medizinische Fakultaet der Humboldt-Universitaet Berlin, Germany, and GE Medical Systems (T.N.), Milwaukee, Wisc.

^* To whom correspondence should be addressed. E-mail: friedrich{at}fvk-berlin.de.

Background--Blood oxygen level-dependent (BOLD) MRI reflects tissue oxygenation and may be useful for the detection of myocardial ischemia in patients with suspected coronary artery disease.

Methods and Results--We studied 25 patients with stress-induced angina using a T₂*-sensitive echo planar imaging sequence before and during adenosine in a single-slice approach. BOLD-MRI results were compared with quantitative angiography and adenosine thallium single-photon emission computed tomography (SPECT). Although image quality was variable because of artifacts, no data were excluded from the analysis. During adenosine, a mean signal intensity decrease was observed for myocardial segments related to coronary stenoses >75%. On average, a nonsignificant increase was observed in the other segments. The angiographically determined stenosis was correlated with BOLD-MRI results. Including all segments and using BOLD-MRI signal intensity increase cutoff value of 1.2%, BOLD-MRI had a sensitivity of 88% and a specificity of 47% to correctly classify severe stenoses. Adenosine thallium SPECT data from distal segments of the same coronary territory were also correlated with BOLD-MRI. However, variability was substantial.

Conclusions--In patients with stress-induced angina, adenosine BOLD-MRI detects myocardial ischemia in myocardial segments related to severe coronary stenoses. Its potential will increase with additional improvement of spatial coverage and image quality.

Key words: magnetic resonance imaging • perfusion • adenosine • coronary heart disease • ischemia

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