The aim of this study was to compare the diagnostic accuracy of perfusion and wall motion (WM) during dipyridamole magnetic resonance in patients with chest pain syndrome. Ninety-three patients with normal baseline left ventricular function were referred for coronary angiography. Additional dipyridamole stress magnetic resonance testing (0.84 mg/kg over 6 minutes; using a Signa Cvi scanner) was performed. Cardiac-gated fast gradient-echo train sequences with a first pass of gadolinium contrast medium were used to assess myocardial perfusion. A perfusion reserve index was calculated as the ratio of dipyridamole to rest upslope. A perfusion reserve index value 1.54 in 2 contiguous myocardial segments was the perfusion positivity criterion. The WM positivity criterion was a segmental score increase of or or =2 segments. WM and the perfusion reserve index showed similar diagnostic accuracy for 50% quantitatively assessed coronary diameter reduction (86% for both), with WM having higher specificity (96% vs 66%, p 0.01) and lower sensitivity (82% vs 93%, p 0.05) than the perfusion reserve index. Perfusion had the highest accuracy values for coronary stenoses 75% (cutoff 59%) and WM for coronary stenoses or
Head to head comparison between perfusion and function during accelerated high-dose dipyridamole magnetic resonance stress for the detection of coronary artery disease
Pingitore A;Aquaro G D;Positano V;Picano E
2008
Abstract
The aim of this study was to compare the diagnostic accuracy of perfusion and wall motion (WM) during dipyridamole magnetic resonance in patients with chest pain syndrome. Ninety-three patients with normal baseline left ventricular function were referred for coronary angiography. Additional dipyridamole stress magnetic resonance testing (0.84 mg/kg over 6 minutes; using a Signa Cvi scanner) was performed. Cardiac-gated fast gradient-echo train sequences with a first pass of gadolinium contrast medium were used to assess myocardial perfusion. A perfusion reserve index was calculated as the ratio of dipyridamole to rest upslope. A perfusion reserve index value 1.54 in 2 contiguous myocardial segments was the perfusion positivity criterion. The WM positivity criterion was a segmental score increase of or or =2 segments. WM and the perfusion reserve index showed similar diagnostic accuracy for 50% quantitatively assessed coronary diameter reduction (86% for both), with WM having higher specificity (96% vs 66%, p 0.01) and lower sensitivity (82% vs 93%, p 0.05) than the perfusion reserve index. Perfusion had the highest accuracy values for coronary stenoses 75% (cutoff 59%) and WM for coronary stenoses orFile | Dimensione | Formato | |
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Descrizione: Head to head comparison between perfusion and function during accelerated high-dose dipyridamole magnetic resonance stress for the detection of coronary artery disease
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