Dynamic 3-Dimensional Stress Cardiac Magnetic Resonance Perfusion Imaging: Detection of Coronary Artery Disease and Volumetry of Myocardial Hypoenhancement Before and After Coronary Stenting

Objectives m of this study was to establish a new, dynamic 3-dimensional cardiac magnetic resonance (3D-CMR) perfusion scan technique exploiting data correlation in k-space and time with sensitivity-encoding and to determine its value for the detection of coronary artery disease (CAD) and volumetry of myocardial hypoenhancement (VOLUMEhypo) before and after percutaneous coronary stenting. ound c 3D-CMR perfusion imaging might improve detection of myocardial perfusion deficits and could facilitate direct volumetry of myocardial hypoenhancement. s patients with known or suspected CAD, a 3.0-T CMR examination was performed including cine imaging, 3D-CMR perfusion under adenosine stress and at rest followed by delayed enhancement imaging. Quantitative invasive coronary angiography defined significant CAD (≥50% luminal narrowing). Forty-eight patients underwent an identical repeat CMR examination after percutaneous stenting of at least 1 coronary lesion. The 3D-CMR perfusion scans were visually classified as pathologic if ≥1 segment showed an inducible perfusion deficit in the absence of delayed enhancement. The VOLUMEhypo was measured by segmentation of the area of inducible hypoenhancement and normalized to left-ventricular myocardial volume (%VOLUMEhypo). s -CMR perfusion resulted in a sensitivity, specificity, and diagnostic accuracy of 91.7%, 74.3%, and 82.9%, respectively. Before and after coronary stenting, %VOLUMEhypo averaged to 14.2 ± 9.5% and 3.2 ± 5.2%, respectively, with a relative VOLUMEhypo reduction of 79.4 ± 25.4%. Intrareader and inter-reader reproducibility of VOLUMEhypo measurements was high (Linʹs concordance correlation coefficient, 0.96 and 0.96, respectively). sions -CMR stress perfusion provided high image quality and high diagnostic accuracy for the detection of significant CAD. The VOLUMEhypo measurements were highly reproducible and allowed for the assessment of the treatment effect achievable by percutaneous coronary stenting.