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Published online before print July 19, 2002, 10.1148/radiol.2243010945
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(Radiology 2002;224:845-851.)
© RSNA, 2002

Cardiac Imaging

Real-Time MR Image Acquisition during High-Dose Dobutamine Hydrochloride Stress for Detecting Left Ventricular Wall-Motion Abnormalities in Patients with Coronary Arterial Disease1

Simon Schalla, MD, Christoph Klein, MD, Ingo Paetsch, MD, Hans Lehmkuhl, MD, Axel Bornstedt, PhD, Bernhard Schnackenburg, PhD, Eckart Fleck, MD and Eike Nagel, MD

1 From the Department of Internal Medicine-Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (S.S., C.K., I.P., H.L., A.B., E.F., E.N.); and Philips Medical Systems, Hamburg, Germany (B.S.). Received May 23, 2001; revision requested June 25; final revision received February 15, 2002; accepted March 5. Supported in part by the German Heart Institute Berlin Foundation and Philips Medical Systems, Hamburg, Germany and Best, the Netherlands. Address correspondence to E.N. (e-mail: eike.nagel@dhzb.de).

PURPOSE: To compare the accuracy of real-time magnetic resonance (MR) imaging with that of standard echo-planar MR imaging for detecting myocardial wall-motion abnormalities at rest and during dobutamine hydrochloride–induced stress in patients with coronary arterial disease.

MATERIALS AND METHODS: In 22 patients with coronary arterial disease, left ventricular wall motion was examined at rest and during dobutamine hydrochloride stress, by using echo-planar MR imaging and a new technique with real-time segmented k-space turbo gradient-echo echo-planar MR imaging (repetition time, 16.5 msec; echo time, 6.8 msec). Wall-motion abnormalities were determined visually for each perfusion territory, and Cohen {kappa} coefficients were calculated for real-time imaging in comparison with echo-planar imaging. Coronary angiography was performed in all patients. Sensitivity and specificity for real-time and echo-planar imaging were calculated for detecting significant coronary arterial stenosis.

RESULTS: {kappa} values for detecting wall-motion abnormalities at real-time imaging, in comparison with echo-planar MR imaging, were 0.97 at rest and 0.94 at maximum dobutamine hydrochloride stress. At comparison with those of angiography, the sensitivity and specificity for detecting significant coronary arterial stenosis were 88% (14 of 16 patients) and 83% (five of six patients), respectively, for echo-planar imaging and 81% (13 of 16 patients) and 83% (five of six patients), respectively, for real-time imaging.

CONCLUSION: Real-time MR imaging is possible under stress conditions and allows accurate detection of wall-motion abnormalities.

© RSNA, 2002

Index terms: Coronary vessels, diseases, 54.76 • Coronary vessels, stenosis or obstruction, 54.76 • Heart, MR, 51.121412, 51.121416, 51.12144, 51.12149 • Magnetic resonance (MR), comparative studies, 51.121416, 51.121419 • Magnetic resonance (MR), motion studies, 51.12144




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