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Single-Vessel Coronary Artery Stenosis: Myocardial Perfusion Imaging with Gadomer-17 First-Pass MR Imaging in a Swine Model of Comparison with Gadopentetate Dimeglumine¹

¹ From the Departments of Medicine, Division of Cardiology (B.L.G., A.W.H., J.A.C.L.), and Radiology (D.A.B., B.B.C., D.L.K.), Johns Hopkins Medical Institutions, 601 N Caroline St, Suite 4231, Baltimore, MD 21287-0845; and Department of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pa (R.C.B.). From the 2000 RSNA scientific assembly. Received August 13, 2001; revision requested October 10; final revision received April 2, 2002; accepted April 12. Supported by grants from Schering, Berlin, Germany, and Berlex Laboratories, Wayne, NJ. Address correspondence to D.L.K. (e-mail: dara@mri.jhu.edu).

PURPOSE: To evaluate the ability of Gadomer-17 to depict perfusion defects in a closed-chest swine model of single-vessel coronary artery disease.

MATERIALS AND METHODS: Twelve pigs underwent closed-chest placement of a flow reducer for 70%–90% luminal stenosis in the proximal left anterior coronary artery. Magnetic resonance (MR) perfusion imaging with Gadomer-17 and gadopentetate dimeglumine, microsphere blood flow (MBF) testing, and technetium 99m (^99mTc) 2 methoxyisobutylisonitrile (MIBI) single photon emission computed tomography (SPECT) were performed during dipyridamole vasodilation. Comparisons of percentage signal intensity (SI) increase (PSIC) in remote and ischemic myocardium were made with repeated measurements analysis of variance after injection of both tracers.

RESULTS: Perfusion defects and reduced PSIC in the anterior ischemic versus the inferior remote myocardium could be identified after injection of both Gadomer-17 (PSIC, 66% ± 30 [mean ± SD] vs 100% ± 32, respectively; P < .001) and gadopentetate dimeglumine (PSIC, 49% ± 31 vs 81% ± 43, respectively; P < .005). The size of perfusion defect depicted with both tracers was highly correlated with defect size at ^99mTc MIBI SPECT (r = 0.69, P < .05 for Gadomer-17 and r = 0.60, P = .05 for gadopentetate dimeglumine) and with areas of reduced MBF (r = 0.70, P < .05 for Gadomer-17 and r = 0.80, P < .05 for gadopentetate dimeglumine). PSIC also correlated with MBF (r = 0.89, P < .001 for Gadomer-17 and r = 0.75, P < .001 for gadopentetate dimeglumine). Gadomer-17 allowed differentiation of ischemic from nonischemic myocardium, as demonstrated by reduced PSIC (PSIC, 48% ± 38 vs 72% ± 31, respectively; P < .001) until 20 minutes after contrast material injection. In contrast, differentiation of ischemic from nonischemic myocardium was possible only until 55 seconds after injection of gadopentetate dimeglumine (PSIC, 36% ± 24 vs 56% ± 27, respectively; P < .005) but not at any time point thereafter.

CONCLUSION: With the study conditions, Gadomer-17 provided more prolonged differentiation of ischemic from remote myocardium than that with gadopentetate dimeglumine.

© RSNA, 2002

Index terms: Animals • Heart, perfusion, 511.12144 • Magnetic resonance (MR), contrast enhancement, 511.12143 • Magnetic resonance (MR), contrast media, 511.12143 • Myocardium, blood supply, 511.76, 511.771 • Myocardium, MR, 511.121412, 511.12143 • Myocardium, SPECT, 511.12162

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