Abstract 1970: Combined Coronary Artery Imaging, Myocardial Perfusion and Delayed Enhancement in Patients With Suspected Coronary Artery Disease
Introduction: MRI offers a combination of functional studies for the detection of ischemia, detection and quantification of myocardial infarction as well as coronary angiography.
Purpose: Aim of the study was to evaluate the feasibility and diagnostic accuracy of the combination of stress (adenosine) perfusion (PERF), delayed enhancement (DE) and coronary angiography (MRCA).
Methods: 54 patients with suspected CAD underwent MR imaging including LV-function, MRCA (SSFP, SENSE factor 1.7, spatial resolution 0.7×0.7×.0.9 mm, T2 prep, fat suppression, trigger delay and temporal resolution adjusted to individual diastolic coronary rest period, TE/TR 2.3/4.6, FA 100°), stress PERF (adenosine 140 μg/min/kg body weight), rest PERF (SSFP, TE/TR 2.7/1.4, FA 50°, 3 slices per heart beat) and DE (3D inversion recovery technique, TE/TR 2.8/6.6, FA 15°, ) using Gd-BOPTA (MultiHance) one day before invasive coronary angiography. Images were analysed visually and graded positive, if one test was pathological. Stenosis >50% in invasive angiography was considered significant.
Results: The prevalence of CAD was 48%. Four percent (2/54) of PERF and 15% of MRCAs (8/54) had non diagnostic image quality. Mean study time was 68±11min. Table⇓ shows the resullts for each test and for combined evaluation. The combination of stress PERF and DE led to the best results. Adding the results of MRCA increased sensitivity, but decreased specificity due to a high rate of false positive readings. If only patients with very good image quality (IQ) in MRCA were analysed (n=17), sensitivity was increased with only little loss of specificity.
Conclusion: The combination of PERF, DE and MRCA is feasible, combining stress perfusion and delayed enhancement yields the highest accuracy. MRCA may be of additional value only if very good IQ can be achieved.