Cardiovascular Magnetic Resonance Perfusion Imaging at 3-Tesla for the Detection of Coronary Artery DiseaseA Comparison With 1.5-Tesla
Adrian S.H. Cheng, MBBS, MRCP*, ,1,4,
Tammy J. Pegg, MBChB, MRCP*,2,4,
Theodoros D. Karamitsos, MD*,,2,3,
Nick Searle, DCR(R) ,
Michael Jerosch-Herold, PhD||,
Robin P. Choudhury, DM, MRCP ,
Adrian P. Banning, MD, FRCP, FESC,
Stefan Neubauer, MD, FRCP*,,
Matthew D. Robson, PhD*, and
Joseph B. Selvanayagam, DPhil, FRACP, FESC*,,2,*
* University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
Department of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom
Department of Radiology, John Radcliffe Hospital, Oxford, United Kingdom
Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom
|| Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon.
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Figure 1 Examples of Agreement Between the 2 Field Strengths for the Identification of Significant Coronary Artery Disease
The angiogram of Patient #1 (top row) in the right lateral (right anterior oblique 90°) projection demonstrates a subtotally occluded left anterior descending (LAD) coronary artery after the bifurcation of the first diagonal (between the 2 full black arrows). The LAD continues partially filled (indicated by the 3 intermittent black arrows) and the LAD territory is partially collateralized from the diagonal branch. There are corresponding stress perfusion deficits in the anteroseptal and inferoseptal segments at both field strengths (white arrows). Patient #2 (bottom row) had a 70% stenosis in the right coronary artery, with corresponding perfusion deficits at 1.5- and 3-Tesla (T) imaging (white arrows).
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Figure 2 Examples of the Superiority of 3-T Imaging When Compared to 1.5-T
Patient #1 (top row) has a 70% stenosis of the left anterior descending (LAD) coronary artery. Whereas 3-Tesla (T) imaging demonstrates a corresponding stress perfusion deficit in the anteroseptal segment, visual assessment of the 1.5-T scan failed to delineate a deficit. Patient #2 (bottom row) had significant multivessel coronary artery disease (left system not shown). Although 1.5-T imaging demonstrates a perfusion deficit of the anterior segment (white arrow), corresponding to a LAD coronary stenosis, it fails to identify a perfusion deficit relating to the 90% stenosis in the right coronary artery. The 3-T imaging detects reversible perfusion deficits in the anterior, anteroseptal, inferoseptal, and inferior segments (white arrows), corresponding to significant stenoses in the left anterior descending and right coronary arteries.
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Figure 3 Receiver-Operating Characteristic Curves
(A) Receiver-operating characteristic curves for visual assessment of 1.5- and 3-Tesla (T) perfusion imaging for the correct identification of significant coronary artery disease. There was no significant difference in diagnostic performance of perfusion imaging between the field strengths (p = 0.23). (B) Receiver-operating characteristic curves for visual assessment of 1.5- and 3-T perfusion imaging for the correct identification of single vessel disease. The diagnostic performance of 3-T perfusion imaging was significantly greater (p < 0.05). (C) Receiver-operating characteristic curves for visual assessment of 1.5- and 3-T perfusion imaging for the correct identification of multivessel disease. The diagnostic performance of 3-T perfusion imaging was significantly greater (p < 0.05). AUC = area under the curve.
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Figure 4 Boxplot Graphs Demonstrating a Significant Increase in Both SNR and CNR at 3-T Compared With 1.5-T
(A) Signal-to-noise ratio (SNR). (B) Contrast-to-noise ratio (CNR). p < 0.01 for both. T = Tesla.
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