Document Detail


The delay of contrast arrival in magnetic resonance first-pass perfusion imaging: a novel non-invasive parameter detecting collateral-dependent myocardium.
MedLine Citation:
PMID:  17344328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral-dependent myocardium in patients with coronary artery disease.
DESIGN AND SETTING: Observational study, case series; single centre, university hospital.
PATIENTS: 30 patients with coronary artery disease and collateral-dependent myocardium and 17 healthy volunteers.
METHODS: Resting and hyperaemic (adenosine) MRPI was used to determine the delay time (Deltat(d)) of contrast arrival between the left ventricle and collateral-dependent or antegradely perfused myocardium, and myocardial perfusion (MP, ml/min/g).
RESULTS: In healthy volunteers, mean (SD) Deltat(d) at rest and during hyperaemia were 0.8 (0.4) and 0.3 (0.3) s, and MP was 1.14 (0.21) and 4.23 (1.12) ml/min/g. In patients Deltat(d) in antegradely perfused vs collateral-dependent myocardium was 0.9 (0.7) vs 1.7 (1.0) s at rest (p<0.001), and 0.4 (0.3) vs 1.1 (0.6) s (p<0.001) during hyperaemia. MP was 1.12 (0.11) and 0.98 (0.28) ml/min/g (p = NS) at rest and 2.46 (0.85) vs 1.86 (0.91) ml/min/g (p<0.01) during hyperaemia. Receiver operating characteristics analysis showed the best sensitivity and specificity of 90% and 83% for hyperaemic Deltat(d) of >0.6 s (area under the curve (AUC) = 0.89) to detect collateral-dependent myocardium, while resting Deltat(d) (AUC = 0.77) and perfusion (AUC = 0.69 at rest or 0.70 during hyperaemia) were less accurate.
CONCLUSIONS: MRPI-derived hyperaemic delay of contrast arrival detects collateral-dependent myocardium with high sensitivity and specificity. Perfusion was less sensitive, emphasising the clinical role of Deltat(d) in non-invasive detection of collateral-dependent myocardium.
Authors:
O M Muehling; A Huber; C Cyran; S O Schoenberg; M Reiser; G Steinbeck; M Nabauer; M Jerosch-Herold
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-03-07
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  93     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-07-20     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  842-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine and Radiology, University of Munich, Munich, Germany. olaf.muehling@med.uni-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Collateral Circulation / physiology*
Contrast Media / pharmacokinetics*
Coronary Angiography
Coronary Disease / diagnosis*,  physiopathology
Female
Gadolinium DTPA / pharmacokinetics*
Humans
Magnetic Resonance Angiography / standards
Male
Middle Aged
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
R01 HL65394-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
Heart. 2007 Jul;93(7):778-9   [PMID:  17569798 ]

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