Document Detail

Magnetic resonance versus radionuclide pharmacological stress perfusion imaging for flow-limiting stenoses of varying severity.
MedLine Citation:
PMID:  15210596     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although magnetic resonance first-pass imaging (MRFP) has potential advantages in pharmacological stress perfusion imaging, direct comparisons of current MRFP and established radionuclide techniques are not available. METHODS AND RESULTS: Graded regional differences in coronary flow were produced during global coronary vasodilation in chronically instrumented dogs by partially occluding the left circumflex artery. Regional differences in full-thickness flow quantified using microspheres were compared with regional differences obtained with MRFP and radionuclide SPECT imaging (99mTc-sestamibi and 201Tl). Relative regional flows (RRFs) derived from the initial areas under MRFP signal intensity-time curves were linearly related to reference microsphere RRFs over the full range of vasodilation (y=0.93x+4.3; r2=0.77). Relationships between 99mTc-sestamibi and 201Tl RRFs and microsphere RRFs were curvilinear, plateauing as flows increased. The high spatial resolution of the MRI enabled transmural flow to be evaluated in 3 to 5 layers across the myocardial wall. Reductions in subendocardial flow were visually apparent in MRFP images for > or =50% reductions in full-thickness flow. Endocardial-to-epicardial gradients in MRFP flow increased progressively with stenosis severity, whereas transmural flow patterns in remote normally perfused myocardium remained normal. Flow reductions of > or =50% not identified by radionuclide imaging were apparent in MRFP full-thickness and transmural analyses. CONCLUSIONS: High-resolution MRFP can identify regional reductions in full-thickness myocardial blood flow during global coronary vasodilation over a wider range than current SPECT imaging. Transmural flow gradients can also be identified; their magnitude increases progressively as flow limitations become more severe and endocardial flow is compromised increasingly.
Daniel C Lee; Orlando P Simonetti; Kathleen R Harris; Thomas A Holly; Robert M Judd; Edwin Wu; Francis J Klocke
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2004-06-21
Journal Detail:
Title:  Circulation     Volume:  110     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-07     Completed Date:  2004-12-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  58-65     Citation Subset:  AIM; IM    
Feinberg Cardiovascular Research Institute, Chicago, IL 60611, USA.
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MeSH Terms
Coronary Circulation*
Coronary Stenosis / diagnosis*,  radionuclide imaging
Magnetic Resonance Imaging*
Tomography, Emission-Computed, Single-Photon*
Grant Support
Reg. No./Substance:

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