Multislice MRI in Assessment of Myocardial Perfusion in Patients With Single-Vessel Proximal Left Anterior Descending Coronary Artery Disease Before and After Revascularization

Abstract

Background Our purpose was to use multislice MRI for detection of reversible myocardial ischemia and assessment of the effect of revascularization on tissue perfusion in patients with coronary artery disease. Methods and Results Eleven patients with single-vessel proximal left anterior descending coronary artery disease were studied with MRI and thallium scintigraphy before and 3 months after revascularization. All patients had a reversible perfusion defect by scintigraphy before treatment. With a 1.5-T MR imager, IR-prepared turboflash images were acquired in three left ventricular short-axis planes during 0.05 mmol/kg Gd-DTPA bolus at rest and with dipyridamole-induced stress. Before treatment, stress increased enhancement slope in normal (6.4±4.4 to 7.4±5.0 s⁻¹, P<.04) and decreased it in underperfused (5.4±3.7 to 2.6±1.4 s⁻¹, P<.02) regions, resulting in a contrast-to-noise ratio of 6.87±3.09 in underperfused myocardium. Revascularization normalized enhancement patterns of the formerly underperfused myocardium and decreased defect size both in scintigraphy (66±53° to 8±12°, P<.001) and MRI sections (49±41° to 9±8°, P<.001). Agreement of 85% in detection and correlation of 0.86 (SEE, 21°, P<.001) in sizing perfusion defects was found between MRI and scintigraphy. Conclusions Multislice contrast-enhanced MRI can be used to detect myocardial perfusion defects in patients with coronary artery disease and in assessment of the effect of treatment on myocardial perfusion.