Myocardial Perfusion Magnetic Resonance Imaging for Diagnosing Coronary Arterial Stenosis

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  • Kinoshita Manabu
    Division of Cardiology, Kagawa Prefectural Shirotori Hospital
  • Nomura Masahiro
    Second Department of Internal Medicine, School of Medicine, University of Tokushima
  • Harada Masafumi
    Department of Radiology, School of Medicine, University of Tokushima
  • Bando Shigenobu
    Division of Cardiology, Kagawa Prefectural Shirotori Hospital
  • Nakaya Yutaka
    Department of Nutrition, School of Medicine, University of Tokushima
  • Ito Susumu
    Second Department of Internal Medicine, School of Medicine, University of Tokushima

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タイトル別名
  • <b>Evaluation by Signal-intensity Time Curves</b>

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説明

It has been reported that myocardial perfusion MRI is a useful method for evaluating the severity of myocardial ischemia. We evaluated whether the severity of coronary arterial stenosis could be assessed by the signal-intensity time curve (SITC) obtained by myocardial perfusion MRI.<br> The subjects consisted of 10 patients who showed no abnormalities on coronary angiographies (CAG) (A group), 12 with single-vessel disease of 75-90% stenosis on CAG (B group), and 15 with single-vessel disease of 90% or more stenosis (C group). After infusion of dipyridamole for 4 minutes, gadolinium-diethylenetriamine pentaacetic acid was administered intravenously, followed by serial acquisition of T1-weighted left ventricular short-axis MR images. These images were evaluated after dividing them into the following 3 myocardial segments: anterior wall, lateral wall, and inferior wall. Mean values of the slope of SITC (1.4 ± 0.2 vs 1.1 ± 0.2, P < 0.01), and increases to the peak corrected SI (ΔSI) (47.5 ± 1.9 % vs 33.7 ± 2.4%, P < 0.01) in normal myocardial segments were significantly greater than in ischemic segments in the C group, while there was no significant distinction between normal and ischemic segments in the B group. The mean values of time to the peak SI were not significantly different between normal and ischemic regions in the B and C groups.<br> The results suggest that myocardial segments exhibiting 30% decreases in both the slope and ΔSI of SITC can be diagnosed as having 90% or more severe coronary stenosis. The present study shows that visual and SITC evaluations of myocardial perfusion MR images may be useful for clinically evaluating the severity of coronary stenosis.<br>

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