Dark-rim-free ungated first-pass perfusion CMR with 3-Slice end-systolic imaging: initial experience
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KeywordsMyocardial Perfusion Imaging Suspected Coronary Artery Disease Myocardial Perfusion Imaging Study Nuclear Myocardial Perfusion Imaging Radial Acquisition
First-pass perfusion (FPP) cardiac MR (CMR) imaging has been shown to have a high performance for diagnosis of coronary artery disease (CAD). Reliability of FPP imaging, however, is hindered by dark-rim artifacts (DRAs) and the need for near-perfect ECG gating. The latter can be challenging in the presence of arrhythmias or heart-rate variations during stress. Moreover, end-systolic (ES) imaging has recently been shown to provide improved visualization of subendocardial defects . We developed an innovative ungated FPP technique capable of simultaneously eliminating DRAs [2, 3] and enabling reconstruction of all slices at ES. We hypothesized that the developed method achieves DRA-free imaging and high accuracy in patients with suspected CAD, using nuclear myocardial perfusion imaging (MPI) as the reference.
Conventional FPP methods are prone to DRAs, require accurate ECG gating, and do not provide the freedom to image all slices at ES. The developed method overcomes these challenges and is an attractive alternative with the advantage of simplicity (no gating), higher accuracy in the subendocardium (no DRAs, ES imaging), and thereby potentially improved reliability. Preliminary results in healthy volunteers and patients with suspected CAD were of high quality and showed high accuracy compared to nuclear MPI.
Grant sponsors: National Institutes of Health grants nos. NHLBI R01HL38698 and R01HL091989. American Heart Association Postdoctoral Fellowship Award 11POST7390063.
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