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Myocardial Perfusion after Angioplasty in Patients Suspected of Having Single-Vessel Coronary Artery Disease: Improvement Detected at Rest-Stress First-Pass Perfusion MR Imaging—Initial Experience¹

¹ From the Departments of Diagnostic Radiology (M.F., N.I.S., U.K., C.D.C., S.M.) and Internal Medicine, Division of Cardiology (A.F., U.H.), Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str 3, 72076 Tuebingen, Germany. Received June 9, 2004; revision requested August 20; revision received October 20; accepted December 10. Address correspondence to M.F. (e-mail: michael.fenchel{at}med.uni-tuebingen.de).

PURPOSE: To prospectively assess myocardial perfusion before and after successful intervention in patients suspected of having single-vessel coronary artery disease by using a steady-state free precession (SSFP) perfusion magnetic resonance (MR) imaging sequence.

MATERIALS AND METHODS: Local ethics committee approval and informed consent were obtained. Rest-stress perfusion MR imaging studies were performed in 18 patients with coronary artery disease (12 men, six women; mean age, 58.6 years ± 13.6 [standard deviation]; range, 30–79 years) at 1.5 T with a multisection saturation-recovery SSFP sequence and 0.025 mmol gadopentetate dimeglumine per kilogram of body weight. MR studies were performed before (n = 18), several days after (n = 18), and 8 months after (n = 10) coronary intervention. Nine patients underwent percutaneous transluminal coronary angioplasty (PTCA) alone, and nine patients underwent PTCA with stent placement. Myocardial perfusion reserve index (MPRI) was calculated by dividing results of myocardial perfusion at maximal vasodilation by results at rest. The standard for myocardial perfusion was technetium 99m tetrofosmin single photon emission computed tomography. Statistical significance was tested with univariate variance analysis and Student t tests.

RESULTS: In the area of the stenosed vessel, MPRI was 1.04 ± 0.24 before treatment and 2.18 ± 0.57 several days afterward (P < .001). In remote areas, MPRI was 2.42 ± 0.44. In the stent group, MPRI increased by 156%, from 0.99 ± 0.20 before stent placement to 2.53 ± 0.53 after (P < .001). Similarly, in the PTCA only group, MPRI increased by 72%, from 1.08 ± 0.27 before PTCA to 1.87 ± 0.39 after (P < .001). At follow-up in patients without recurring chest pain, MPRI was 2.14 ± 0.37 in the area of the treated artery and 2.29 ± 0.47 in remote areas (P = .06).

CONCLUSION: The MPRI, derived from rest-stress examinations, can provide information on success of interventional procedures in stenosed coronary arteries.

© RSNA, 2005

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