Abstract 11247: 1.5T and 3T Quantitative Myocardial Perfusion Reserve for Detection of Relevant Coronary Artery Stenosis - A Comparison to Fractional Flow Reserve

Abstract

Background: FFR is considered by many investigators to be a reliable standard to determine hemodynamic significant coronary artery stenosis. Quantitative perfusion analysis at 1.5T and 3T CMR is capable to noninvasively determine myocardial perfusion reserve, but have yet to be compared validated against FFR. The objective of this study was to compare quantitative analysis of cardiac magnetic resonance (CMR) perfusion at 1.5T and 3T against fractional flow reserve (FFR) as measured invasively.

Methods: Patients with suspected or known coronary artery disease (CAD) underwent CMR at both field strengths, 1.5T and 3T, and FFR. Quantitative myocardial perfusion reserve was calculated in 544 myocardial segments at 1.5T and 3T, respectively. FFR was measured in 109 coronary arteries. FFR ≤0.8 was regarded as hemodynamic relevant.

Results: Reduced FFR (≤ 0.8) was found in 38 coronary arteries (19 LAD, 8 LCX and 11 RCA). Receiver operator curve analysis yielded higher area under the curve for 3T CMR in comparison to 1.5T CMR (0.963 vs. 0.645, p<0.001) resulting in higher sensitivity (90.5% vs. 61.9%) and specificity (100% vs. 76.9%).

Conclusions: Quantitative analysis of CMR myocardial perfusion reserve at 1.5T and 3T is capable to detect hemodynamic significance of coronary artery stenoses. Diagnostic accuracy at 3T is to be superior to 1.5T.