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AJR 2001; 177:1161-1166
© American Roentgen Ray Society

Assessing Coronary Sinus Blood Flow in Patients with Coronary Artery Disease

A Comparison of Phase-Contrast MR Imaging with Positron Emission Tomography

Juha W. Koskenvuo1, Jaakko J. Hartiala1, Juhani Knuuti2, Hajime Sakuma3, Jyri O. Toikka1, Markku Komu4, Markku Saraste1 and Pekka Niemi4

1 Department of Clinical Physiology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
2 Turku PET Centre, University of Turku, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
3 Department of Radiology, Mie University Hospital, 2174 Edobashi, Tsu, Mie 514-8507, Japan.
4 Department of Radiology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.

OBJECTIVE. This study was performed to determine whether MR imaging can be used to reliably measure global myocardial blood flow and coronary flow reserve in patients with coronary artery disease as compared with such measurements obtained by positron emission tomography (PET).

SUBJECTS AND METHODS. We measured myocardial blood flow first at baseline and then after dipyridamole-induced hyperemia in 20 patients with coronary artery disease. Myocardial blood flow as revealed by MR imaging was calculated by dividing coronary sinus flow by the left ventricular mass. Coronary flow reserve was calculated by dividing the rate of hyperemic flow by the rate of baseline flow.

RESULTS. Using MR imaging, myocardial blood flow at baseline was 0.73 ± 0.23 mL·min-1·g-1, and at hyperemia the blood flow was 1.43 ± 0.37 mL·min-1·g-1, yielding an average coronary flow reserve of 1.99 ± 0.47. Using PET, myocardial blood flow was 0.89 ± 0.21 mL·min-1·g-1 at baseline and 1.56 ± 0.42 mL·min-1·g-1 at hyperemia, yielding an average coronary flow reserve of 1.77 ± 0.36. The correlation of myocardial blood flow and coronary flow reserve measurements for these two methods was an r of 0.80 (p < 0.01) and an r of 0.50 (p < 0.05), respectively.

CONCLUSION. This study shows that myocardial blood flow measurements obtained using MR imaging have a good correlation with corresponding PET measurements. Coronary flow reserve measurements obtained using MR imaging had only moderate correlation with PET-obtained measurements. Our results suggest that MR imaging flow quantification could potentially be used for measuring global myocardial blood flow in patients in whom interventional treatment for coronary artery disease is being evaluated.


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