Yasuyuki Kobayashi MD, Presenter: Nothing to Disclose

Takanori Yasu MD, Abstract Co-Author: Nothing to Disclose

Osamu Tanaka MD, Abstract Co-Author: Nothing to Disclose

Katsuhiko Matsuura MD, Abstract Co-Author: Nothing to Disclose

Muneyasu Saitou MD, Abstract Co-Author: Nothing to Disclose

Kenji Yodo, Abstract Co-Author: Nothing to Disclose

Pharmacological stress perfusion MRI and MSCT is attracting widespread interest as a technique for the assessment of myocardial perfusion. We have reported that high-dose Nicorandil is known to increase coronary blood flow, which duration of action is 2 to 3 minutes and effects on hemodynamics are minimal. These characteristics of Nicorandil lead to expectations that it is safe and simple to use. The objective is to assess the efficacy and safety of Nicorandil in stress perfusion MRI and MSCT.

The subjects were 201 patients with angina pectoris or myocardial infarction. Perfusion MRI was performed in 160 patients and perfusion MSCT was performed in 41 patients. 1.5T MRI (Excelart, Toshiba) and 4 and 16-slice MSCT (Aquilion, Toshiba) were used. Immediately after an intravenous injection of Nicorandil(8mg), MRI or MSCT acquisition was started. We examined, 1) the presence of complications, 2) early defect (ED) in short axial images of stress perfusion MRI, and 3) ED in reconstructed short axial images using perfusion MSCT data. These findings were compared with the findings obtained by coronary angiography(CAG).

1) No complication was observed in the 201 cases. 2) ED in Perfusion MRI: The results of 63 cases were compared with the findings obtained by CAG. The sensitivity and specificity to detect significant coronary artery stenosis (≧75%) was 82% and 85% respectively for RCA, 93% and 73% for LAD, 82% and 76% for LCX and 87% and 79% for overall. 3) ED in Perfusion MSCT: The results of 20 patients were compared with CAG. The sensitivity and specificity to detect significant coronary artery stenosis (≧75%) was 75% and 83% respectively for RCA, 93% and 50% for LAD, 82% and 100% for LCX and 85% and 82% for overall. Nicorandil was suitable for use in pharmacological stress perfusion MSCT because the quality of MSCT images was affected by increases in heart rate, and Nicorandil did not increase heart rate as much as other drugs did.

Nicorandil is most useful and safe drug for pharmacological stress perfusion MRI and MSCT for the assessment of ischemic heart disease.

Kobayashi, Y, Yasu, T, Tanaka, O, Matsuura, K, Saitou, M, Yodo, K, Efficacy of Nicorandil in Perfusion MRI and MSCT for the Assessment of Ischemic Heart Disease.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416227.html