Abstract 3776: Adenosine Stress MR Perfusion and MR Viability Imaging for Detection of Hemodynamically Relevant Coronary Artery Disease. A Prospective Study for Comparison with Perfusion Scintigraphy and Coronary Angiography
Background Contrast enhanced magnetic resonance imaging (MRI) allows visualization of both myocardial perfusion and myocardial scar tissue. However, it is unknown whether this new diagnostic technique has the same diagnostic value as myocardial single photon emission computed tomography (SPECT). This prospective study aimed to validate the diagnostic value of adenosine stress MRI with viability imaging, in comparison to 201Tl SPECT and x-ray coronary angiography as the gold standard.
Methods and Results 86 patients (63 men; mean age 62±9 yrs.) with suspected CAD or suspected progression underwent cardiac MRI with adenosine stress for myocardial perfusion imaging and viability imaging, 201Tl SPECT, and coronary angiography. There was better correlation of MRI data with coronary angiography findings (r=0.88) than SPECT data with angiography findings (r=0.59) The sensitivity and specificity for detection of significant coronary artery stenoses was 92 % and 95 % respectively for MRI and 82 % and 77 % respectively for SPECT. Positive and negative predictive values were 98 % and 90 % respectively for MRI compared with 83 % and 75 % respectively for SPECT.
Conclusion In this study adenosine stress MR perfusion including viability imaging is superior to SPECT in detecting significant coronary artery disease. MRI is a very fast imaging modality and in comparison to SPECT has higher spatial resolution and is free of ionizing radiation. Moreover, it provides additional accurate data about cardiac dimensions as well as functional and morphological characteristics. However, experienced readers are needed for appropriate visual analysis of dynamic perfusion images.