Abstract 330: Bold-sensitive Magnetic Resonance Imaging for Evaluation of Myocardial Perfusion Reserve
Background: Diagnosis of inducible myocardial ischemia is important for decision of further diagnosis and therapy in coronary artery disease (CAD). Blood-oxygen level dependent (BOLD) cardiac magnetic resonance imaging (CMR) is a potential method to evaluate myocardial perfusion reserve alternatively to first-pass perfusion using contrast agents.
Methods: We imaged 39 patients with suspected CAD on a 1.5T whole-body CMR scanner using a T2-prepared steady-state free-precession (SSFP) BOLD sensitive sequence and a SSFP-based first-pass sequence. All patients were scanned during rest and after three minutes of adenosine infusion (140 μg/kg/min). For myocardial first-pass visualization 0.1 mmol/kg Gadolinium-based contrast agent was used.
Results: In 72 of 587 analyzed segments a first-pass perfusion deficit could be seen. Relative BOLD signal increase during adenosine infusion was significantly lower in patients with perfusion deficit compared to patients without perfusion deficit (p<0.0001). Patients with non-transmural and with transmural first-pass perfusion deficit also differed significantly for BOLD signal increase (p<0.01). ROC analysis showed an area under the curve of 0.84 for the T2-prepared SSFP sequence regarding detection of inducible perfusion deficit.
Conclusions: A good correlation between myocardial perfusion as visualized by contrast-enhanced first-pass perfusion during adenosine infusion and rest and BOLD signal increase could be shown. Hence, T2-prepared BOLD imaging allows for visualization of myocardial perfusion reserve in a clinical setting without use of exogenous contrast agent.