High spatial resolution myocardial perfusion imaging during high dose dobutamine/atropine stress magnetic resonance using κ-t SENSE
International Journal of Cardiology, 07/16/2012

R. Gebker et al. – High spatial resolution DSMR–perfusion imaging at maximum stress level was feasible, improved sensitivity over DSMR–wall motion for the detection of coronary artery disease (CAD) and allowed an accurate determination of disease extent. Specificity of DSMR–perfusion with κ–t SENSE improved compared to prior studies using lower spatial resolution.

• DSMR–wall motion was combined with perfusion imaging (DSMR–perfusion) in 78 patients prior to clinically indicated invasive coronary angiography.
• For DSMR–perfusion an in–plane spatial resolution of 1.5×1.5mm2 was attained by using 8× κ–space and time sensitivity encoding (κ–t SENSE).
• Image quality and extent of artifacts during perfusion imaging were evaluated.
• Wall motion and perfusion data were interpreted sequentially.
• Significant CAD (stenosis ≥70%) was present in 52 patients and involved 86 coronary territories.

• One patient did not reach target heart rate despite maximum infusion of dobutamine/atropine.
• Two studies (3%) were non–diagnostic due κ–t SENSE related artifacts resulting from insufficient breathhold capability.
• Overall image quality was good.
• Dark–rim artifacts were limited to the endocardial border at a mean width of 1.8mm.
• The addition of DSMR–perfusion to DSMR–wall motion data improved sensitivity for the detection of CAD (92% vs. 81%, P=0.03) and accurate determination of disease extent (85% vs. 66% of territories, P<0.001).
• There were no significant differences between DSMR–perfusion and DSRM–wall motion regarding overall specificity (83% vs. 87%, P=1) and accuracy (89% vs. 83%, P=0.13).