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Diagnostic Accuracy of Stress First-Pass Contrast-Enhanced Myocardial Perfusion MRI Compared with Stress Myocardial Perfusion Scintigraphy

Hajime Sakuma1, Naohisa Suzawa2, Yasutaka Ichikawa2, Katsutoshi Makino3, Tadanori Hirano2, Kakuya Kitagawa1 and Kan Takeda1

1 Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
2 Department of Radiology, Matsusaka Central Hospital, Matsusaka, Mie, Japan.
3 Department of Internal Medicine, Matsusaka Central Hospital, Matsusaka, Mie, Japan.



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  		Fig. 1A —58-year-old woman with chest pain during exercise. First-pass contrast-enhanced MR images (2 R-R intervals/1.2 ms/58 ms [repetition time msec/TE msec/inversion time msec]) obtained during stress and at rest. First row shows stress images and second row shows rest images.

 


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  		Fig. 1B —58-year-old woman with chest pain during exercise. Thallium-201 SPECT images obtained during stress and at rest in patient with significant stenosis in left anterior descending artery. In A, hypoperfused region (white arrows) in anterior wall is depicted as region of lower enhancement during stress. In B, stress-induced ischemia (arrows) is depicted in anterior wall.

 


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  		Fig. 2A —60-year-old man with chest pain during exercise. First-pass contrast-enhanced MR images (2 R-R intervals/1.2/58 [repetition time msec/TE msec/inversion time msec]) obtained during stress and at rest. First row shows stress images and second row shows rest images.

 


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  		Fig. 2B —60-year-old man with chest pain during exercise. Thallium-201 SPECT images obtained during stress and at rest in patient with significant stenosis in right coronary artery. In A, hypoperfused region (white arrows) in inferior wall is depicted as region of lower enhancement during stress. In B, stress-induced ischemia (arrows) is depicted in inferior wall.

 



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  		Fig. 3 —Receiver operating characteristic curves of stress first-pass contrast-enhanced MRI and thallium-201 SPECT in detecting significant stenoses in individual coronary arteries revealed by selective coronary artery angiography in 40 patients. No statistically significant difference was observed between stress first-pass contrast-enhanced MRI and 201Tl SPECT for both observers. A shows results from observer 1 and B, from observer 2. n.s. = not significant.

 


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  		Fig. 4 —First-pass contrast-enhanced MR images (2 R-R intervals/1.2 ms/58 ms [repetition time msec/TE msec/inversion time msec]) obtained during stress and at rest in patient with normal coronary artery. Subendocardial hypointensity was observed around circumference (arrows) of left ventricle on stress perfusion MR images. However, subendocardial hypointensity was observed to similar extent on rest perfusion MR images. Therefore, hypointensity area was considered to be artifact. First row shows stress images and second row shows rest images.

 

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