Additional value of myocardial perfusion imaging during dobutamine stress magnetic resonance for the assessment of coronary artery disease.
نویسندگان
چکیده
BACKGROUND Dobutamine stress magnetic resonance (DSMR) imaging has emerged as a valuable tool for the detection of inducible wall motion abnormalities. The role of perfusion imaging during DSMR is not well defined. We examined whether the addition of myocardial perfusion imaging during DSMR provides incremental benefit for the evaluation of coronary artery disease. METHODS AND RESULTS DSMR was combined with perfusion imaging in 455 consecutive patients who were scheduled for clinically indicated invasive coronary angiography. Perfusion images were acquired in 3 standard short-views at rest and during maximum dobutamine-atropine stress. Wall motion and perfusion images were interpreted sequentially, blinded to other data. Significant (> or =70%) stenoses were present in 285 patients on invasive coronary angiography. The use of DSMR combined with perfusion imaging versus DSMR increased sensitivity (91% versus 85%, P=0.001), but not specificity (70% versus 82%, P=0.001), resulting in identical overall diagnostic accuracy (84% versus 84%, P=NS; Youden index 0.61 versus 0.67). DSMR combined with perfusion imaging enabled the correct diagnosis of coronary artery disease in an additional 13% of DSMR-negative patients at the cost of 11% more false-positive cases. CONCLUSIONS The addition of perfusion imaging during DSMR improves sensitivity for the diagnosis of coronary artery disease but does not enhance overall diagnostic accuracy because of a concomitant decrease in specificity.
منابع مشابه
Comparison of dobutamine stress magnetic resonance, adenosine stress magnetic resonance, and adenosine stress magnetic resonance perfusion.
BACKGROUND Dobutamine stress MR (DSMR) is highly accurate for the detection of inducible wall motion abnormalities (IWMAs). Adenosine has a more favorable safety profile and is well established for the assessment of myocardial perfusion. We evaluated the diagnostic value of IWMAs during dobutamine and adenosine stress MR and adenosine MR perfusion compared with invasive coronary angiography. ...
متن کاملPrognostic value of high-dose dobutamine stress magnetic resonance imaging in 1,493 consecutive patients: assessment of myocardial wall motion and perfusion.
OBJECTIVES This study sought to determine the prognostic value of wall motion and perfusion assessment during high-dose dobutamine stress (DS) cardiac magnetic resonance imaging (MRI) in a large patient cohort. BACKGROUND DS-MRI offers the possibility to integrate myocardial perfusion and wall motion analysis in a single examination for the detection of coronary artery disease (CAD). METHOD...
متن کاملCardiac Magnetic Resonance Imaging in Ischemic Heart Disease
Cardiac magnetic resonance imaging (MRI) has emerged as a prime player in the clinical and preclinical detection of ischemic heart disease (IHD) as well in the prognosis assessment by offering a comprehensive approach for all spectrums of coronary artery disease (CAD) patients. The aim of this review is to provide the reader a state-of-the art on how the newest cardiac MRI techniques can be use...
متن کاملRelationship between Late Gadolinium Enhancement Extent in Cardiac Magnetic Resonance Imaging and Severity of Coronary Artery Disease in Old Myocardial Infarction
Purpose: To assess the relationship between the severity of coronary arteries involvement and the extent and pattern of myocardial scars in Cardiac Magnetic Resonance of patients with history of remote myocardial infarction. Materials and Methods: The Cardiac Magnetic Resonance images of sixty patients with history of remote ST segment or non-ST segment elevation myocardial infarction were ...
متن کاملDobutamine induced myocardial perfusion reserve index with cardiovascular MR in patients with coronary artery disease.
Currently, adenosine or dipyridamole is commonly used for the assessment of perfusion reserve. With intolerance to these agents, dobutamine can be used alternatively or it can be used for a combined examination of wall motion and perfusion. The aim of the study was to analyze the feasibility of cardiovascular magnetic resonance (CMR) to assess perfusion reserve with dobutamine. Alterations of m...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Circulation. Cardiovascular imaging
دوره 1 2 شماره
صفحات -
تاریخ انتشار 2008