Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 8/2012

01.12.2012 | Original paper

Quantification of myocardial perfusion reserve at 1.5 and 3.0 Tesla: a comparison to fractional flow reserve

verfasst von: Peter Bernhardt, Thomas Walcher, Wolfgang Rottbauer, Jochen Wöhrle

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 8/2012

Einloggen, um Zugang zu erhalten

Abstract

The objective of this study was to compare quantitative analysis of cardiac magnetic resonance (CMR) perfusion at 1.5 and 3 T against fractional flow reserve (FFR) as measured invasively. FFR is considered by many investigators to be a reliable standard to determine hemodynamically significant coronary artery stenoses. Quantitative 1.5 and 3 T CMR is capable to noninvasively determine myocardial perfusion reserve, but have not been compared against each other and validated against FFR as standard reference. Patients with suspected or known coronary artery disease (CAD) underwent CMR at at both field strengths, 1.5 and 3 T, and FFR. 34 patients were included into the study. Quantitative myocardial perfusion reserve was calculated in 544 myocardial segments at 1.5 and 3 T, respectively. FFR was measured in 109 coronary arteries. FFR ≤ 0.8 was regarded relevant. 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 3 T CMR in comparison to 1.5 T CMR (0.963 vs. 0.645, p < 0.001) resulting in higher sensitivity (90.5 vs. 61.9 %) and specificity (100 vs. 76.9 %). Quantitative analysis of CMR myocardial perfusion reserve at 1.5 and 3 T is capable to detect hemodynamic significance of coronary artery stenoses. Diagnostic accuracy at 3 T is to be superior to 1.5 T.
Literatur
1.
Zurück zum Zitat Shaw LJ, Hachamovitch R, Heller GV, Marwick TH, Travin MI, Iskandrian AE, Kesler K, Lauer MS, Hendel R, Borges-Neto S, Lewin HC, Berman DS, Miller D (2000) Noninvasive strategies for the estimation of cardiac risk in stable chest pain patients. The Economics of Noninvasive Diagnosis (END) Study Group. Am J Cardiol 86:1–7PubMedCrossRef Shaw LJ, Hachamovitch R, Heller GV, Marwick TH, Travin MI, Iskandrian AE, Kesler K, Lauer MS, Hendel R, Borges-Neto S, Lewin HC, Berman DS, Miller D (2000) Noninvasive strategies for the estimation of cardiac risk in stable chest pain patients. The Economics of Noninvasive Diagnosis (END) Study Group. Am J Cardiol 86:1–7PubMedCrossRef
2.
Zurück zum Zitat Beller GA, Zaret BL (2000) Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease. Circulation 101:1465–1478PubMedCrossRef Beller GA, Zaret BL (2000) Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease. Circulation 101:1465–1478PubMedCrossRef
3.
Zurück zum Zitat Gibbons RS (1996) American Society of Nuclear Cardiology project on myocardial perfusion imaging: measuring outcomes in response to emerging guidelines. J Nucl Cardiol 3:436–442PubMedCrossRef Gibbons RS (1996) American Society of Nuclear Cardiology project on myocardial perfusion imaging: measuring outcomes in response to emerging guidelines. J Nucl Cardiol 3:436–442PubMedCrossRef
4.
Zurück zum Zitat Bech GJ, De Bruyne B, Bonnier HJ, Bartunek J, Wijns W, Peels K, Heyndrickx GR, Koolen JJ, Pijls NH (1998) Long-term follow-up after deferral of percutaneous transluminal coronary angioplasty of intermediate stenosis on the basis of coronary pressure measurement. J Am Coll Cardiol 31:841–847PubMedCrossRef Bech GJ, De Bruyne B, Bonnier HJ, Bartunek J, Wijns W, Peels K, Heyndrickx GR, Koolen JJ, Pijls NH (1998) Long-term follow-up after deferral of percutaneous transluminal coronary angioplasty of intermediate stenosis on the basis of coronary pressure measurement. J Am Coll Cardiol 31:841–847PubMedCrossRef
5.
Zurück zum Zitat Rieber J, Schiele TM, Koenig A, Erhard I, Segmiller T, Stempfle HU, Theisen K, Jung P, Siebert U, Klauss V (2002) Long-term safety of therapy stratification in patients with intermediate coronary lesions based on intracoronary pressure measurements. Am J Cardiol 90:1160–1164PubMedCrossRef Rieber J, Schiele TM, Koenig A, Erhard I, Segmiller T, Stempfle HU, Theisen K, Jung P, Siebert U, Klauss V (2002) Long-term safety of therapy stratification in patients with intermediate coronary lesions based on intracoronary pressure measurements. Am J Cardiol 90:1160–1164PubMedCrossRef
6.
Zurück zum Zitat Pijls NH, Klauss V, Siebert U, Powers E, Takazawa K, Fearon WF, Escaned J, Tsurumi Y, Akasaka T, Samady H, De Bruyne B (2002) Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter registry. Circulation 105:2950–2954PubMedCrossRef Pijls NH, Klauss V, Siebert U, Powers E, Takazawa K, Fearon WF, Escaned J, Tsurumi Y, Akasaka T, Samady H, De Bruyne B (2002) Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter registry. Circulation 105:2950–2954PubMedCrossRef
7.
Zurück zum Zitat Bernhardt P, Steffens M, Kleinertz K, Morell R, Budde R, Leischik R, Krämer A, Overhoff U, Strohm O (2006) Safety of adenosine stress magnetic resonance imaging using a mobile cardiac magnetic resonance system. J Cardiovasc Magn Reson 8:475–478PubMedCrossRef Bernhardt P, Steffens M, Kleinertz K, Morell R, Budde R, Leischik R, Krämer A, Overhoff U, Strohm O (2006) Safety of adenosine stress magnetic resonance imaging using a mobile cardiac magnetic resonance system. J Cardiovasc Magn Reson 8:475–478PubMedCrossRef
8.
Zurück zum Zitat Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, Marincek B, Luscher TF, von Schulthess GK (2001) Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation 103:2230–2235PubMedCrossRef Schwitter J, Nanz D, Kneifel S, Bertschinger K, Buchi M, Knusel PR, Marincek B, Luscher TF, von Schulthess GK (2001) Assessment of myocardial perfusion in coronary artery disease by magnetic resonance: a comparison with positron emission tomography and coronary angiography. Circulation 103:2230–2235PubMedCrossRef
9.
Zurück zum Zitat Ishida N, Sakuma H, Motoyasu M, Okinaka T, Isaka N, Nakano T, Takeda K (2003) Noninfarcted myocardium: correlation between dynamic first-pass contrast-enhanced myocardial MR imaging and quantitative coronary angiography. Radiology 229:209–216PubMedCrossRef Ishida N, Sakuma H, Motoyasu M, Okinaka T, Isaka N, Nakano T, Takeda K (2003) Noninfarcted myocardium: correlation between dynamic first-pass contrast-enhanced myocardial MR imaging and quantitative coronary angiography. Radiology 229:209–216PubMedCrossRef
10.
Zurück zum Zitat Al Saadi N, Nagel E, Gross M, Bornstedt A, Schnackenburg B, Klein C, Klimek W, Oswald H, Fleck E (2000) Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance. Circulation 101:1379–1383PubMedCrossRef Al Saadi N, Nagel E, Gross M, Bornstedt A, Schnackenburg B, Klein C, Klimek W, Oswald H, Fleck E (2000) Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance. Circulation 101:1379–1383PubMedCrossRef
11.
Zurück zum Zitat Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K, Fleck E (2003) Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Circulation 108:432–437PubMedCrossRef Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K, Fleck E (2003) Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Circulation 108:432–437PubMedCrossRef
12.
Zurück zum Zitat Merkle N, Wöhrle J, Grebe O, Nusser T, Kunze M, Kestler HA, Kochs M, Hombach V (2007) Assessment of myocardial perfusion to detect coronary artery stenoses by steady-state-free-precession magnetic resonance first-pass imaging. Heart 93:1381–1385PubMedCrossRef Merkle N, Wöhrle J, Grebe O, Nusser T, Kunze M, Kestler HA, Kochs M, Hombach V (2007) Assessment of myocardial perfusion to detect coronary artery stenoses by steady-state-free-precession magnetic resonance first-pass imaging. Heart 93:1381–1385PubMedCrossRef
13.
Zurück zum Zitat Bernhardt P, Levenson B, Albrecht A, Engels T, Strohm O (2007) Detection of cardiac small vessel disease by adenosine-stress magnetic resonance. Int J Cardiol 121:261–266PubMedCrossRef Bernhardt P, Levenson B, Albrecht A, Engels T, Strohm O (2007) Detection of cardiac small vessel disease by adenosine-stress magnetic resonance. Int J Cardiol 121:261–266PubMedCrossRef
14.
Zurück zum Zitat Wilke NM, Jerosch-Herold M, Zenovisch A, Stillman AE (1999) Magnetic resonance first-pass myocardial perfusion imaging: clinical validation and future applications. J Magn Reson Imaging 10:676–685PubMedCrossRef Wilke NM, Jerosch-Herold M, Zenovisch A, Stillman AE (1999) Magnetic resonance first-pass myocardial perfusion imaging: clinical validation and future applications. J Magn Reson Imaging 10:676–685PubMedCrossRef
15.
Zurück zum Zitat Lee DC, Simonetti OP, Harris KR, Holly TA, Judd RM, Wu E, Klocke FJ (2004) Magnetic resonance versus radionuclide pharmacological stress perfusion imaging for flow limiting stress stenoses of varying severity. Circulation 110:48–65 Lee DC, Simonetti OP, Harris KR, Holly TA, Judd RM, Wu E, Klocke FJ (2004) Magnetic resonance versus radionuclide pharmacological stress perfusion imaging for flow limiting stress stenoses of varying severity. Circulation 110:48–65
16.
Zurück zum Zitat Rieber J, Huber A, Erhard I, Mueller S, Schweyer M, Koenig A, Schiele TM, Theisen K, Siebert U, Schoenberg SO, Reiser M, Klauss V (2006) Cardiac magnetic resonance perfusion imaging for the functional assessment of coronary artery disease: a comparison with coronary angiography and fractional flow reserve. Eur Heart J 27:1465–1471PubMedCrossRef Rieber J, Huber A, Erhard I, Mueller S, Schweyer M, Koenig A, Schiele TM, Theisen K, Siebert U, Schoenberg SO, Reiser M, Klauss V (2006) Cardiac magnetic resonance perfusion imaging for the functional assessment of coronary artery disease: a comparison with coronary angiography and fractional flow reserve. Eur Heart J 27:1465–1471PubMedCrossRef
17.
Zurück zum Zitat Costa MA, Shoemaker S, Futumatsu H, Klassen C, Angiolillo DJ, Nguyen M, Siuciak A, Gilmore P, Zenni MM, Guzman L, Bass TA, Wilke N (2007) Quantitative magnetic resonance perfusion imaging detects anatomic and physiologic coronary artery disease as measured by coronary angiography and fractional flow reserve. J Am Coll Cardiol 50:514–522PubMedCrossRef Costa MA, Shoemaker S, Futumatsu H, Klassen C, Angiolillo DJ, Nguyen M, Siuciak A, Gilmore P, Zenni MM, Guzman L, Bass TA, Wilke N (2007) Quantitative magnetic resonance perfusion imaging detects anatomic and physiologic coronary artery disease as measured by coronary angiography and fractional flow reserve. J Am Coll Cardiol 50:514–522PubMedCrossRef
18.
Zurück zum Zitat Watkins S, McGeoch R, Lyne J, Steedman T, Good R, McLaughlin MJ, Cunningham T, Bezlyak V, Ford I, Dargie HJ, Oldroyd KG (2009) Validation of magnetic resonance myocardial perfusion imaging with fractional flow reserve for the detection of significant coronary heart disease. Circulation 120:2207–2213PubMedCrossRef Watkins S, McGeoch R, Lyne J, Steedman T, Good R, McLaughlin MJ, Cunningham T, Bezlyak V, Ford I, Dargie HJ, Oldroyd KG (2009) Validation of magnetic resonance myocardial perfusion imaging with fractional flow reserve for the detection of significant coronary heart disease. Circulation 120:2207–2213PubMedCrossRef
19.
Zurück zum Zitat Wen H, Denison TJ, Singerman RW, Balaban RS (1997) The intrinsic signal-to-noise ratio in human cardiac imaging at 1.5, 3, and 4 T. J Magn Reson 125:65–71PubMedCrossRef Wen H, Denison TJ, Singerman RW, Balaban RS (1997) The intrinsic signal-to-noise ratio in human cardiac imaging at 1.5, 3, and 4 T. J Magn Reson 125:65–71PubMedCrossRef
20.
Zurück zum Zitat Greenman RL, Shirosky JE, Mulkern RV, Rofsky NM (2003) Double inversion black-blood fast spin-echo imaging of the human heart: a comparison between 1.5T and 3.0T. J Magn Reson Imaging 17:648–655PubMedCrossRef Greenman RL, Shirosky JE, Mulkern RV, Rofsky NM (2003) Double inversion black-blood fast spin-echo imaging of the human heart: a comparison between 1.5T and 3.0T. J Magn Reson Imaging 17:648–655PubMedCrossRef
21.
Zurück zum Zitat Araoz PA, Glockner JF, McGee KP, Potter DD Jr, Valeti VU, Stanley DW, Christian TF (2005) 3 Tesla MR imaging provide improved contrast in first-pass myocardial perfusion imaging over a range of gadolinium doses. J Cardiovasc Magn Reson 7:559–565PubMedCrossRef Araoz PA, Glockner JF, McGee KP, Potter DD Jr, Valeti VU, Stanley DW, Christian TF (2005) 3 Tesla MR imaging provide improved contrast in first-pass myocardial perfusion imaging over a range of gadolinium doses. J Cardiovasc Magn Reson 7:559–565PubMedCrossRef
22.
Zurück zum Zitat Cheng ASH, Pegg TJ, Karamitsos TD, Searle N, Jerosch-Herold M, Choudhury RP, Banning AP, Neubauer S, Robson MD, Selvanayagam JB (2007) Cardiovascular magnetic resonance perfusion imaging at 3-Tesla for the detection of coronary artery disease. J Am Coll Cardiol 49:2440–2449PubMedCrossRef Cheng ASH, Pegg TJ, Karamitsos TD, Searle N, Jerosch-Herold M, Choudhury RP, Banning AP, Neubauer S, Robson MD, Selvanayagam JB (2007) Cardiovascular magnetic resonance perfusion imaging at 3-Tesla for the detection of coronary artery disease. J Am Coll Cardiol 49:2440–2449PubMedCrossRef
23.
Zurück zum Zitat Koenig W, Khuseyinova N (2007) Biomarkers of atherosclerotic plaque instability and rupture. Arterioscler Thromb Vasc Biol 27:15–26PubMedCrossRef Koenig W, Khuseyinova N (2007) Biomarkers of atherosclerotic plaque instability and rupture. Arterioscler Thromb Vasc Biol 27:15–26PubMedCrossRef
24.
Zurück zum Zitat Assmann G, Cullen P, Schulte H (2002) Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Münster (PROCAM) study. Circulation 105:310–315PubMedCrossRef Assmann G, Cullen P, Schulte H (2002) Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Münster (PROCAM) study. Circulation 105:310–315PubMedCrossRef
25.
Zurück zum Zitat Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology at the American Heart Association. Circulation 105:539–542PubMedCrossRef Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology at the American Heart Association. Circulation 105:539–542PubMedCrossRef
26.
Zurück zum Zitat Ortiz-Pérez JT, Rodríguez J, Meyers SN, Lee DC, Davidson C, Wu E (2008) Correspondence between the 17-segment model and coronary arterial anatomy using contrast-enhanced cardiac magnetic resonance imaging. J Am Coll Cardiol Img 1:282–293 Ortiz-Pérez JT, Rodríguez J, Meyers SN, Lee DC, Davidson C, Wu E (2008) Correspondence between the 17-segment model and coronary arterial anatomy using contrast-enhanced cardiac magnetic resonance imaging. J Am Coll Cardiol Img 1:282–293
27.
Zurück zum Zitat Al-Saadi N, Nagel E, Gross M, Bornstedt A, Schnackenburg B, Klein C, Klimek W, Oswald H, Fleck E (2000) Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance. Circulation 101:1379–1383PubMedCrossRef Al-Saadi N, Nagel E, Gross M, Bornstedt A, Schnackenburg B, Klein C, Klimek W, Oswald H, Fleck E (2000) Noninvasive detection of myocardial ischemia from perfusion reserve based on cardiovascular magnetic resonance. Circulation 101:1379–1383PubMedCrossRef
28.
Zurück zum Zitat Pijls NH, van Son JA, Kirkeeide RL, De Bruyne B, Gould KL (1993) Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation 86:1354–1367CrossRef Pijls NH, van Son JA, Kirkeeide RL, De Bruyne B, Gould KL (1993) Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation 86:1354–1367CrossRef
29.
Zurück zum Zitat Lockie T, Ishida M, Perera D, Chiribiri A, De Silva K, Kozerke S, Marber M, Nagel E, Rezavi R, Redwood S, Plein S (2011) High-resolution magnetic resonance myocardial perfusion imaging at 3.0-Tesla to detect hemodynamically significant coronary stenoses as determined by fractional flow reserve. J Am Coll Cardiol 57:70–75PubMedCrossRef Lockie T, Ishida M, Perera D, Chiribiri A, De Silva K, Kozerke S, Marber M, Nagel E, Rezavi R, Redwood S, Plein S (2011) High-resolution magnetic resonance myocardial perfusion imaging at 3.0-Tesla to detect hemodynamically significant coronary stenoses as determined by fractional flow reserve. J Am Coll Cardiol 57:70–75PubMedCrossRef
Metadaten
Titel
Quantification of myocardial perfusion reserve at 1.5 and 3.0 Tesla: a comparison to fractional flow reserve
verfasst von
Peter Bernhardt
Thomas Walcher
Wolfgang Rottbauer
Jochen Wöhrle
Publikationsdatum
01.12.2012
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 8/2012
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-012-0037-1

Weitere Artikel der Ausgabe 8/2012

The International Journal of Cardiovascular Imaging 8/2012 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.