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Published online before print August 30, 2002, 10.1148/radiol.2251011377
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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

Bernhard L. Gerber, MD, PhD, David A. Bluemke, MD, PhD, Bennett B. Chin, MD, Raymond C. Boston, PhD, Alan W. Heldman, MD, João A. C. Lima, MD and Dara L. Kraitchman, VMD, PhD

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).



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  		Figure 1a. (a) Nylon coronary flow reducer (arrow) on guide wire adjacent to coronary angioplasty balloon. (b) Representative angiogram in the left anterior oblique view shows 90% stenosis (arrow) of the proximal left anterior descending coronary artery after insertion of the device.

 


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  		Figure 1b. (a) Nylon coronary flow reducer (arrow) on guide wire adjacent to coronary angioplasty balloon. (b) Representative angiogram in the left anterior oblique view shows 90% stenosis (arrow) of the proximal left anterior descending coronary artery after insertion of the device.

 


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  		Figure 2. MR perfusion images acquired with a saturation-recovery fast gradient-echo sequence with echo-planar readout (6.2/1.2/160 [repetition time msec/echo time msec/inversion time msec], field of view of 28 x 21 cm, flip angle of 20°, and echo train length of four) with Gadomer-17, gadopentetate dimeglumine (Gd-DTPA), and 99mTc MIBI SPECT show a perfusion defect (arrows) in the anterior region during pharmacologic vasodilation with dipyridamole.

 


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  		Figure 3. Bar graph depicts mean perfusion defect size (area with less than 60% of maximum peak SI) with Gadomer-17 or gadopentetate dimeglumine (Gd-DTPA) perfusion MR imaging and with 99mTc MIBI SPECT. Error bars = SDs, * = P < .05 compared with Gadomer-17 or gadopentetate dimeglumine. The extent of the perfusion defect was similar with Gadomer-17 or gadopentetate dimeglumine but was significantly larger as measured with both MR perfusion tracers than the size of the defect measured with 99mTc MIBI SPECT.

 


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  		Figure 4a. Line graphs depict time-activity curves with (a) Gadomer-17 or (b) gadopentetate dimeglumine in a representative animal with stenosis without infarct of the proximal left anterior descending coronary artery. Results with both tracers demonstrate higher SI increase in the inferior remote myocardium than in the anterior myocardium. This finding corresponds to the vascular bed being subtended by the coronary flow reducer.

 


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  		Figure 4b. Line graphs depict time-activity curves with (a) Gadomer-17 or (b) gadopentetate dimeglumine in a representative animal with stenosis without infarct of the proximal left anterior descending coronary artery. Results with both tracers demonstrate higher SI increase in the inferior remote myocardium than in the anterior myocardium. This finding corresponds to the vascular bed being subtended by the coronary flow reducer.

 


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  		Figure 5a. Scatterplots depict correlation between peak PSIC in ischemic and remote myocardium versus relative MBF after injection of (a) Gadomer-17 or (b) gadopentetate dimeglumine (Gd-DTPA). Peak PSIC with both perfusion tracers was highly correlated with relative MBF measurements.

 


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  		Figure 5b. Scatterplots depict correlation between peak PSIC in ischemic and remote myocardium versus relative MBF after injection of (a) Gadomer-17 or (b) gadopentetate dimeglumine (Gd-DTPA). Peak PSIC with both perfusion tracers was highly correlated with relative MBF measurements.

 


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  		Figure 6a. Line graphs depict mean PSIC over time in ischemic ({square}) and remote ({bullet}) myocardium in all 12 animals at different time points after injection of (a) Gadomer-17 or (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote region. Gadomer-17 demonstrated significant reduction of PSIC in anterior ischemic versus remote myocardium until 20 minutes after injection. Such differences in PSIC could be demonstrated only until 50 seconds after injection of gadopentetate dimeglumine.

 


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  		Figure 6b. Line graphs depict mean PSIC over time in ischemic ({square}) and remote ({bullet}) myocardium in all 12 animals at different time points after injection of (a) Gadomer-17 or (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote region. Gadomer-17 demonstrated significant reduction of PSIC in anterior ischemic versus remote myocardium until 20 minutes after injection. Such differences in PSIC could be demonstrated only until 50 seconds after injection of gadopentetate dimeglumine.

 


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  		Figure 7a. Line graphs depict mean PSIC over time in noninfarcted ischemic ({square}) and remote ({bullet}) myocardium in seven animals without transmural infarction and with maintained resting MBF at different time points after injection of (a) Gadomer-17 and (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote area. Gadomer-17 demonstrated significantly lower PSIC in noninfarcted ischemic compared with remote myocardium until 5 minutes after tracer injection. In contrast, such differences persisted only until 50 seconds after injection of gadopentetate dimeglumine.

 


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  		Figure 7b. Line graphs depict mean PSIC over time in noninfarcted ischemic ({square}) and remote ({bullet}) myocardium in seven animals without transmural infarction and with maintained resting MBF at different time points after injection of (a) Gadomer-17 and (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote area. Gadomer-17 demonstrated significantly lower PSIC in noninfarcted ischemic compared with remote myocardium until 5 minutes after tracer injection. In contrast, such differences persisted only until 50 seconds after injection of gadopentetate dimeglumine.

 


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  		Figure 8a. Line graphs depict mean PSIC over time in infarcted myocardium subtended by an occluded coronary artery ({square}) and remote myocardium ({bullet}) in four animals with transmural infarction and reduced resting MBF after injection of (a) Gadomer-17 and (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote area. Gadomer-17 demonstrated significantly reduced PSIC in infarcted compared with remote myocardium until 20 minutes after tracer injection. In contrast, such differences in PSIC existed only until 5 minutes after injection of gadopentetate dimeglumine.

 


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  		Figure 8b. Line graphs depict mean PSIC over time in infarcted myocardium subtended by an occluded coronary artery ({square}) and remote myocardium ({bullet}) in four animals with transmural infarction and reduced resting MBF after injection of (a) Gadomer-17 and (b) gadopentetate dimeglumine. Error bars = standard error of the mean, * = P < .05, {dagger} = P < .01, {ddagger} = P < .005 of ischemic compared with remote area. Gadomer-17 demonstrated significantly reduced PSIC in infarcted compared with remote myocardium until 20 minutes after tracer injection. In contrast, such differences in PSIC existed only until 5 minutes after injection of gadopentetate dimeglumine.

 




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