101. Noninvasive stress testing of myocardial perfusion defects: head-to-head comparison of thallium-201 SPECT to MRI perfusion
- Author
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François Mach, Gabriella Vincenti, Giuseppe Ambrosio, Hestia Imperiano, Osman Ratib, Thomas H. Schindler, Charles Steiner, Rene Nkoulou, and Jean-Paul Vallée
- Subjects
Adult ,Male ,Tomography, Emission-Computed, Single-Photon/*methods ,Stress testing ,Myocardial Ischemia ,Perfusion scanning ,Coronary Artery Disease ,Coronary Angiography ,ddc:616.0757 ,Angina Pectoris ,Coronary artery disease ,Myocardial Ischemia/pathology ,Coronary Artery Disease/diagnosis/radionuclide imaging ,medicine ,Myocardial Perfusion Imaging/*methods ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiac imaging ,Aged ,Tomography, Emission-Computed, Single-Photon ,ddc:616 ,Coronary Angiography/methods ,Thallium Radioisotopes/*diagnostic use ,medicine.diagnostic_test ,business.industry ,Myocardial Perfusion Imaging ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Dipyridamole ,Perfusion ,Stenosis ,Thallium Radioisotopes ,Angina Pectoris/diagnosis/radionuclide imaging ,Female ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Magnetic Resonance Imaging/*methods ,medicine.drug - Abstract
BACKGROUND: To evaluate the diagnostic value of magnetic resonance imaging (MRI) of myocardial perfusion in the assessment of flow-limiting epicardial stenosis in a head-to-head comparison with abnormal thallium-201 ((201)TI) single photon emission tomography (SPECT) studies in patients with predominantly known coronary artery disease (CAD). METHODS AND RESULTS: Twenty-one patients (mean age 65 +/- 10 years) with reversible myocardial perfusion defects on (201)TI-SPECT images during dipyridamole-stimulated hyperemia were recruited for study purpose. Within 5 days of the (201)TI-SPECT study, myocardial perfusion was studied again with MRI during dipyridamole stimulation and at rest. Overall, (201)TI-SPECT identified 30 reversible regional perfusion defects. The sensitivity to detect hypoperfused segments was 70% (21/30) with the GRE-MRI perfusion analysis with (201)TI-SPECT as reference. When patients were subgrouped according to the extent of regional reversible perfusion defects on (201)TI-SPECT, mild- (SDS: 2-4), moderate- (SDS: 5-8), and severe- (SDS > 8) perfusion defects were also identified by GRE-MRI perfusion analysis in 75% (6/8), in 56% (9/16) and 100% (6/6), respectively. CONCLUSIONS: GRE-MRI first-pass stress perfusion imaging may not identify up to 30% of mild-to-moderate perfusion defects in a group of preselected patients with predominantly known CAD and abnormal (201)TI-SPECT studies.
- Published
- 2009