High-Resolution Versus Standard-Resolution Cardiovascular MR Myocardial Perfusion Imaging for the Detection of Coronary Artery Disease

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  • Manish Motwani
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • Neil Maredia
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • Timothy A. Fairbairn
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • Sebastian Kozerke
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • Aleksandra Radjenovic
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • John P. Greenwood
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).
  • Sven Plein
    From the Multidisciplinary Cardiovascular Research Centre & Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds, UK (M.M., N.M., T.A.B., J.P.G., S.P.); the Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland (S.K.); and National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit and School of Medicine, University of Leeds, Leeds, UK (A.R.).

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<jats:sec> <jats:title>Background—</jats:title> <jats:p>Although accelerated high-spatial-resolution cardiovascular MR (CMR) myocardial perfusion imaging has been shown to be clinically feasible, there has not yet been a direct comparison with standard-resolution methods. We hypothesized that higher spatial resolution detects more subendocardial ischemia and leads to greater diagnostic accuracy for the detection coronary artery disease. This study compared the diagnostic accuracy of high-resolution and standard-resolution CMR myocardial perfusion imaging in patients with suspected coronary artery disease.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> A total of 111 patients were recruited to undergo 2 separate perfusion-CMR studies at 1.5 T, 1 with standard-resolution (2.5×2.5 mm in-plane) and 1 with high-resolution (1.6×1.6 mm in-plane) acquisition. High-resolution acquisition was facilitated by 8-fold <jats:italic>k-t</jats:italic> broad linear speed-up technique acceleration. Two observers visually graded perfusion in each myocardial segment on a 4-point scale. Segmental scores were summed to produce a perfusion score for each patient. All patients underwent invasive coronary angiography and coronary artery disease was defined as stenosis ≥50% luminal diameter (quantitative coronary angiography). CMR data were successfully obtained in 100 patients. In patients with coronary artery disease (n=70), more segments were determined to have subendocardial ischemia with high-resolution than with standard-resolution acquisition (279 versus 108; <jats:italic>P</jats:italic> <0.001). High-resolution acquisition had a greater diagnostic accuracy than standard resolution for identifying single-vessel disease (area under the curve, 0.88 versus 0.73; <jats:italic>P</jats:italic> <0.001) or multivessel disease (area under the curve, 0.98 versus 0.91; <jats:italic>P</jats:italic> =0.002) and overall (area under the curve, 0.93 versus 0.83; <jats:italic>P</jats:italic> <0.001). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>High-resolution perfusion-CMR has greater overall diagnostic accuracy than standard-resolution acquisition for the detection of coronary artery disease in both single- and multivessel disease and detects more subendocardial ischemia.</jats:p> </jats:sec>

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