Ulrich Kramer MD, Presenter: Nothing to Disclose

Achim Seeger, Abstract Co-Author: Nothing to Disclose

Christina Doesch, Abstract Co-Author: Nothing to Disclose

Bernhard Klumpp MD, Abstract Co-Author: Nothing to Disclose

Michael Christian Fenchel MD, Abstract Co-Author: Nothing to Disclose

Jörg Döring MD, Abstract Co-Author: Nothing to Disclose

Andreas E. May, Abstract Co-Author: Nothing to Disclose

Claus Detlef Claussen MD, Abstract Co-Author: Nothing to Disclose

Stephan Miller MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

The capability of myocardial perfusion magnetic resonance imaging (MRI) for the detection of coronary artery stenoses in patients suffering from coronary artery disease (CAD) has been proven in several studies. Aim of this prospective study was the assessment of the diagnostic importance of cardiac stress MRI in a non-selective population suspected of having CAD.

MRI at rest and stress (140µg/kg*min adenosine) was performed in 141 consecutive patients (105 male, 36 female, mean 63,4±13,7 yrs) on a 1.5T whole body MR scanner. All patients were scheduled for invasive coronary angiogram, serving as standard of reference. A saturation-recovery turbo-FLASH-2D sequence was used, covering the LV cavity with at least 3 short axis slices (TR 2.2ms, TE 1.1ms, flip 12°, slice thickness 8mm, matrix 192). Image analysis was performed quantitatively and qualitatively by two independent observers; image quality was rated on a five-point scale (score 0-4). Areas of myocardial malperfusion were assigned to coronary territories and correlated to invasive coronary angiograms. Second, a sub-group analysis was performed (single-vessel- vs. multi-vessel-disease).

All studies were performed successfully, safely and without any side-effects related to the administration of adenosine. Overall sensitivity and specificity of cardiac stress MRI in the detection of hemodynamically relevant CAD (stenosis>75%) was 91.3% and 63.4%, respectively. Positive predictive value was 81% and negative predictive value was 85%. Sensitivity decreases when less than a three vessel-disease is present [3-vessel disease (n=44) Sens/Spec 92% / 60%; 2-vessel-disease (n=43) Sens/Spec 91% / 86%; single-vessel-disease (n=27) Sens/Spec 87% / 46%; no CAD (n=27) Sens/Spec 61% / 70%].

Cardiac stress MRI is an accurate tool for the assessment of myocardial perfusion with high sensitivity and specificity. Due to high diagnostic performance and a safe profile of adenosine it can be implemented into any daily routine cardiac examination

Myocardial perfusion MR imaging at rest and stress can serve as a useful screening modality in patients suspected of having CAD.

Kramer, U, Seeger, A, Doesch, C, Klumpp, B, Fenchel, M, Döring, J, May, A, Claussen, C, Miller, S, et al, , et al, , Diagnostic Importance of Cardiac Stress MR Imaging as a Part of Daily Routine Examinations.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011205.html