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A myocardial perfusion reserve index in humans using first-pass contrast-enhanced magnetic resonance imaging

J. H. S. Cullen, MA, MRCP^* , M. A. Horsfield, PhD, MIEE, C. R. Reek, FRCR, G. R. Cherryman, MD, FRCR, D. B. Barnett, MD, FRCP and N. J. Samani, MD, FRCP, FACC^*

^* Division of Cardiology, Department of Medicine and Therapeutics, University of Leicester, Leicester, England, United Kingdom
Department of Clinical Pharmacology, University of Leicester, Leicester, England, United Kingdom
Department of Medical Physics, University of Leicester, Leicester, England, United Kingdom
Department of Radiology, University of Leicester, Leicester, England, United Kingdom

View larger version (20K): [in a new window]   Figure 1 Schematic of left ventricular short-axis oblique slice, showing allocation of the 10 regions of interest to the three coronary arteries in a typical circulation. Left anterior descending artery (LAD) represents regions 8 to 2; circumflex artery (CX) represents regions 3 and 4, and right coronary artery (RCA) represents regions 5 to 7.

View larger version (17K): [in a new window]   Figure 2 Histogram plots of individual resting and stress unidirectional transfer constant (Ki) values in all 10 regions of interest in a normal subject at the papillary level, showing a uniform increase in Ki in all coronary territories with adenosine stress.

View larger version (15K): [in a new window]   Figure 3 Histogram plots of all individual resting and stress unidirectional transfer constant (Ki) values in all 10 regions of interest in a patient at the papillary level, showing significant reduction of the ratio of Ki during stress to Ki at rest in the posterior and anteroseptal walls, due to right coronary and left anterior descending coronary artery disease.

View larger version (10K): [in a new window]   Figure 4 Scatterplot of relation between myocardial perfusion reserve index and percent diameter stenosis of coronary arteries assessed by quantitative arteriography (r = –0.81, p < 0.01).