AIM: To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral-dependent myocardium in patients with coronary artery disease. DESIGN AND SETTING: Observational study, case series; single centre, university hospital. PATIENTS: 30 patients with coronary artery disease and collateral-dependent myocardium and 17 healthy volunteers. METHODS: Resting and hyperaemic (adenosine) MRPI was used to determine the delay time (Deltat(d)) of contrast arrival between the left ventricle and collateral-dependent or antegradely perfused myocardium, and myocardial perfusion (MP, ml/min/g). RESULTS: In healthy volunteers, mean (SD) Deltat(d) at rest and during hyperaemia were 0.8 (0.4) and 0.3 (0.3) s, and MP was 1.14 (0.21) and 4.23 (1.12) ml/min/g. In patients Deltat(d) in antegradely perfused vs collateral-dependent myocardium was 0.9 (0.7) vs 1.7 (1.0) s at rest (p<0.001), and 0.4 (0.3) vs 1.1 (0.6) s (p<0.001) during hyperaemia. MP was 1.12 (0.11) and 0.98 (0.28) ml/min/g (p = NS) at rest and 2.46 (0.85) vs 1.86 (0.91) ml/min/g (p<0.01) during hyperaemia. Receiver operating characteristics analysis showed the best sensitivity and specificity of 90% and 83% for hyperaemic Deltat(d) of >0.6 s (area under the curve (AUC) = 0.89) to detect collateral-dependent myocardium, while resting Deltat(d) (AUC = 0.77) and perfusion (AUC = 0.69 at rest or 0.70 during hyperaemia) were less accurate. CONCLUSIONS: MRPI-derived hyperaemic delay of contrast arrival detects collateral-dependent myocardium with high sensitivity and specificity. Perfusion was less sensitive, emphasising the clinical role of Deltat(d) in non-invasive detection of collateral-dependent myocardium.
AIM: To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral-dependent myocardium in patients with coronary artery disease. DESIGN AND SETTING: Observational study, case series; single centre, university hospital. PATIENTS: 30 patients with coronary artery disease and collateral-dependent myocardium and 17 healthy volunteers. METHODS: Resting and hyperaemic (adenosine) MRPI was used to determine the delay time (Deltat(d)) of contrast arrival between the left ventricle and collateral-dependent or antegradely perfused myocardium, and myocardial perfusion (MP, ml/min/g). RESULTS: In healthy volunteers, mean (SD) Deltat(d) at rest and during hyperaemia were 0.8 (0.4) and 0.3 (0.3) s, and MP was 1.14 (0.21) and 4.23 (1.12) ml/min/g. In patients Deltat(d) in antegradely perfused vs collateral-dependent myocardium was 0.9 (0.7) vs 1.7 (1.0) s at rest (p<0.001), and 0.4 (0.3) vs 1.1 (0.6) s (p<0.001) during hyperaemia. MP was 1.12 (0.11) and 0.98 (0.28) ml/min/g (p = NS) at rest and 2.46 (0.85) vs 1.86 (0.91) ml/min/g (p<0.01) during hyperaemia. Receiver operating characteristics analysis showed the best sensitivity and specificity of 90% and 83% for hyperaemic Deltat(d) of >0.6 s (area under the curve (AUC) = 0.89) to detect collateral-dependent myocardium, while resting Deltat(d) (AUC = 0.77) and perfusion (AUC = 0.69 at rest or 0.70 during hyperaemia) were less accurate. CONCLUSIONS: MRPI-derived hyperaemic delay of contrast arrival detects collateral-dependent myocardium with high sensitivity and specificity. Perfusion was less sensitive, emphasising the clinical role of Deltat(d) in non-invasive detection of collateral-dependent myocardium.
Authors: O M Mühling; M E Dickson; A Zenovich; Y Huang; B V Wilson; R F Wilson; I S Anand; R T Seethamraju; M Jerosch-Herold; N M Wilke Journal: J Cardiovasc Magn Reson Date: 2001 Impact factor: 5.364
Authors: H Wieneke; A Schmermund; J Ge; C Altmann; M Haude; C Von Birgelen; D Baumgart; O Dirsch; R Erbel Journal: Am Heart J Date: 2001-10 Impact factor: 4.749
Authors: R J Kim; E Wu; A Rafael; E L Chen; M A Parker; O Simonetti; F J Klocke; R O Bonow; R M Judd Journal: N Engl J Med Date: 2000-11-16 Impact factor: 91.245
Authors: June Yun; Petra Rocic; Yuh Fen Pung; Souad Belmadani; Ana Catarina Ribeiro Carrao; Vahagn Ohanyan; William M Chilian Journal: Antioxid Redox Signal Date: 2009-08 Impact factor: 8.401
Authors: Maythem Saeed; Alastair Martin; Alexis Jacquier; Matthew Bucknor; David Saloner; Loi Do; Philip Ursell; Hua Su; Yuet W Kan; Charles B Higgins Journal: Radiology Date: 2008-09-09 Impact factor: 11.105