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Titolo:
Assessment of myocardial perfusion in coronary artery disease by magnetic resonance - A comparison with positron emission tomography and coronary angiography
Autore:
Schwitter, J; Nanz, D; Kneifel, S; Bertschinger, K; Buchi, M; Knusel, P; Marincek, B; Luscher, T; von Schulthess, GK;
Indirizzi:
Univ Zurich Hosp, Div Cardiol, CH-8091 Zurich, Switzerland Univ Zurich Hosp Zurich Switzerland CH-8091 CH-8091 Zurich, Switzerland Univ Zurich Hosp, Clin Nucl Med, CH-8091 Zurich, Switzerland Univ Zurich Hosp Zurich Switzerland CH-8091 CH-8091 Zurich, Switzerland Univ Zurich Hosp, Inst Diagnost Radiol, CH-8091 Zurich, Switzerland Univ Zurich Hosp Zurich Switzerland CH-8091 CH-8091 Zurich, Switzerland
Titolo Testata:
CIRCULATION
fascicolo: 18, volume: 103, anno: 2001,
pagine: 2230 - 2235
SICI:
0009-7322(20010508)103:18<2230:AOMPIC>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-FLOW; N-13 AMMONIA; SEVERITY; QUANTIFICATION; STENOSIS; MRI; RESERVE; STRESS; INJURY; SPECT;
Keywords:
imaging; perfusion; heart diseases;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Schwitter, J Univ Zurich Hosp, Div Cardiol, Raemistr 100, CH-8091 Zurich, Switzerland Univ Zurich Hosp Raemistr 100 Zurich Switzerland CH-8091 and
Citazione:
J. Schwitter et al., "Assessment of myocardial perfusion in coronary artery disease by magnetic resonance - A comparison with positron emission tomography and coronary angiography", CIRCULATION, 103(18), 2001, pp. 2230-2235

Abstract

Background-Monitoring contrast medium wash-in kinetics in hyperemic myocardium by magnetic resonance (MR) allows for the detection of stenosed coronary arteries. In this prospective study, the quality of a multislice MR approach with respect to the detection and sizing of compromised myocardium wasdetermined and compared with positron emission tomography (PET) and quantitative coronary angiography. Methods and Results-A total of 48 patients and 18 healthy subjects were studied by MR using a multislice hybrid echo-planar pulse sequence for monitoring the myocardial first pass kinetics of gadolinium-diethylenetriamine pentaacetic acid bismethylamide (Omniscan; 0.1 mmol/kg injected at 3 mL/s IV)during hyperemia (dipyridamole 0.56 mg/kg). Signal intensity upslope as a measure of myocardial perfusion was calculated in 32 sectors per heart frompixelwise parametric maps in the subendocardial layer and for full wall thickness. Before coronary angiography, coronary flow reserve (hyperemia induced by dipyridamole 0.56 mg/kg) was determined in corresponding sectors by N-13-ammonia PET. Receiver-operator characteristic analysis of subendocardial upslope data revealed a sensitivity and specificity of 91% and 94%, respectively, for the detection of coronary artery disease as defined by PET (mean coronary flow reserve minus 2SD of controls) and a sensitivity and specificity of 87% and 85%, respectively, in comparison with quantitative coronary angiography (diameter stenosis greater than or equal to 50%). The number of pathological sectors per patient on PET and MR studies correlated linearly (slope, 0.94, r=0.76; P<0.0001). Conclusions-The presented MR approach reliably identifies patients with coronary artery stenoses and provides information on the amount of compromised myocardium, even when perfusion abnormalities are confined to the subendocardial layer. This modality may qualify for its clinical application in the management of coronary artery disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 06:21:32