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Cardiac Imaging |
1 From the Depts of Radiology (K.L., P.N., H.J.A.), and Medicine, Division of Cardiology and BioMag Laboratory, (H.H., L.T, M.A.M.), Helsinki University Central Hospital (HUCH), Haartmaninkatu 4, 00029 Helsinki, Finland; Dept of Clinical Radiology, Kuopio University Hospital, Finland (H.J.A.); Turku PET Centre, Finland (T.J., L.M.V.P., J.K.); and Laboratory of Biomedical Engineering, Helsinki University of Technology, Finland (T.M.). From the 1999 RSNA scientific assembly. Received Nov 29, 1999; revision requested Jan 14, 2000; revision received Apr 3; accepted Apr 21. Supported by HUCH and Orion research funds, HUCH Foundation, Finnish Cardiac Society, Academy of Finland, and Paavo Nurmi Foundation, Helsinki, Finland. Address correspondence to K.L. (e-mail: kirsi.lauerma@hus.fi).
PURPOSE: To combine three magnetic resonance (MR) imaging modalities—dobutamine stress cine, first pass, and late contrast material–enhanced T1-weighted imaging—and to compare the results with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the assessment of unviable myocardium in coronary artery disease.
MATERIALS AND METHODS: Ten patients with multivessel coronary artery disease underwent MR imaging before and 6 months after bypass surgery. Left ventricular cine MR imaging was performed at rest and during dobutamine infusion. Inversion-recovery gradient-echo images were obtained to study myocardial contrast enhancement at first pass and 5 minutes later. FDG PET was performed with orally administered acipimox before surgery.
RESULTS: With dobutamine cine MR imaging, unviable myocardium was detected with a sensitivity of 79% and a specificity of 93%; postoperative wall thickening was the standard. First-pass analysis increased these values to 97% and 96%; analysis of late enhancement with T1-weighted imaging, to 62% and 98%. FDG PET had a sensitivity of 81% and a specificity of 86%.
CONCLUSION: The combination of first-pass enhancement analysis and wall motion assessment with stress significantly increases the specificity of MR imaging in the detection of unviable sectors.
Index terms: Coronary angiography, comparative studies, 54.1244 • Coronary vessels, stenosis or obstruction, 54.76 • Magnetic resonance (MR), cine study, 524.12144 • Magnetic resonance (MR), comparative studies, 524.121412, 524.121413, 524.12143, 524.12144 • Magnetic resonance (MR), contrast enhancement, 524.12143 • Magnetic resonance (MR), inversion recovery, 524.121413 • Myocardium, infarction, 511.711 • Myocardium, PET, 511.12163
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