Abstract 10725: Fractional Flow Reserve Correlates to Oxygen-sensitive T2-prepared Magnetic Resonance Imaging in Coronary Heart Disease

Abstract

Background: Oxygen-sensitive T2-prepared steady-state free-precession (T2prep SSFP) cardiac magnetic resonance imaging (CMR) has the potential to evaluate myocardial ischemia due to different T2 and T2* relaxations of oxyhemoglobin and deoxyhemoglobin. We assessed the hypothesis that signal intensity increase in T2-prep SSFP is correlated to invasively measured fractional flow reserve (FFR) in coronary artery disease.

Methods: T2prep SSFP sequences were acquired in three short axes (apical, midventricular and basal) at rest and after three minutes of adenosine-infusion at a constant rate of 140 µg/kg/min in a 1.5T whole-body CMR scanner. In each patient 16 myocardial segments were analyzed for relative BOLD signal intensity increase during adenosine in comparison to rest. Invasive FFR measurements were performed in all patients in the major three coronary arteries during adenosine infusion (140 µg/kg/min for three minutes). A FFR ≤0.8 was regarded significant. FFR was compared to CMR results.

Results: Thirty-four patients were included into the study. BOLD signal intensity increase was significantly lower in myocardial segment supplied by coronary arteries with a FFR ≤0.8 (1.08±0.33% vs. 1.50±0.20, p<0.0001 in the LAD; 1.03±0.26% vs. 1.54±0.24%, p<0.0001 in the LCX; 0.90±0.19 vs. 1.53±0.22, p<0.0001 in the RCA. Sensitivity yielded 88.2%, specificity 89.5%.

Conclusion: In conclusion, oxygen-sensitive T2prep SSFP CMR reliably detects hemodynamic significant coronary artery disease and offers an alternative to contrast-enhanced perfusion studies.