Will 3D at 3-T make myocardial stress perfusion magnetic resonance imaging even more competitive?

Currently, two-dimensional (2D) adenosine stress myocardial perfusion cardiac magnetic resonance imaging (MRI) uses 3 to 4 cardiac slices to cover the left ventricular myocardium. Although the performance of 2D adenosine stress myocardial perfusion MRI has been shown to be equal or even better compared with single-photon emission computed tomography (SPECT) because of its superior image resolution, this technique lacks complete myocardial coverage (1). Recent advances in MRI scanner technology and seuence design allow highly accelerated 3D myocardial erfusion imaging with improved signal homogeneity and etter reconstruction accuracy of temporally resolved signal ntensity curves (2). Joyiga et al. (3), in this issue of the ournal, use a 3-T MRI system. Higher field strength mproves substantially image quality and test performance or cardiac stress perfusion imaging compared with lower eld strength MRI (4,5). In this study, the increased ignal-to-noise ratio at 3-T (about 30%) compared with .5-T MRI scanners was used for highly accelerated 3D mage acquisition covering the whole ventricle in 1 hearteat with an acceptable spatial resolution (2.3 2.3 5 m) and diagnostic image quality. The 3D adenosine stress myocardial perfusion MRI study by Jogiya et al. (3) used pressure wire derived fractional flow reserve as an endpoint. They showed improved specificity values with fractional flow reserve compared with quantitative coronary angiography (89.5% vs. 80.0 %), reflecting a lower false positive rate likely related to coronary arteries without functional flow limitation despite appearing significantly narrowed on quantitative coronary angiography. The functional assessment of coronary artery stenosis has been