J Korean Radiol Soc.  1997 Nov;37(5):813-823.

First-pass Perfusion Disturbance of Coronary Artery Stenosis: An Experimental Study Using MR Imaging with Gd-DTPA Enhancement

• Chung KI
• Lim TH
• Lee YJ
• Kim HS
• Soh DM
• Tak SJ
• Wang HJ
• Lee CJ
• Choi BI
• Park CH

Abstract

PURPOSE
In order to determine the value of first-pass MR imaging in the diagnosis of myocardial ischemia, first-pass perfusion abnormality of coronary artery stenosis was observed in MRI after gadopentate dimeglumine (Gd-DTPA) enhancement.
MATERIALS AND METHODS
The left anterior descending (LAD) coronary arteries of six dogs were subjected to approximately 70% stenosis confirmed by coronary angiography. Half an hour after adenosine and 99mTc-sestamibi infusion, Gd-DTPA (0.2 mmol/kg) and methylene blue were administered and termination was induced with potassium chloride. SE T1-weighted and single-photon emission computed tomography (SPECT) images were subsequently obtained and the findings of perfusion defect compared with specimen stain. Three dimensionally reconstructed MR images were used to measure signal intensity (SI) of normal myocardium and perfusion defect from their sectional and total volume.
RESULTS
Five of six dogs with LAD artey stenosis ranging from 66% to 73% displayed perfusion defect on MRI, SPECT, and specimen stain, but the remaining dog with stenosis of 58% showed no such defect. MRI showed the perfusion defect as distinct low SI, enabling the measurement of percentage perfusion defect (24.4+/-5.4%), which increased inferiorly. SI of normal myocardium and perfusion defect decreased inferiorly; their difference indicated stenosis-induced perfusion loss according to section location. Volumetric SI of normal myocardium and perfusion defect were 3.42+/-0.52 and 2.16+/-0.45, respectively (p < 0.05).
CONCLUSION
Gd-DTPA enhanced MRI displayed first-pass perfusion abnormality of coronary artery stenosis as perfusion defect with distinct low SI ; this enabled the measurement of its volume and SI changes according to section location, and thus indicated the value of first-pass MR imaging in the diagnosis of myocardial ischemia.

Keyword

Coronary angiography; Coronary vessels, stenosis or obstruction; Myocardium, ischemia; Myocardium, MR; Myocardium, radionuclide studies

MeSH Terms

Adenosine
Animals
Constriction, Pathologic
Coronary Angiography
Coronary Stenosis*
Coronary Vessels*
Diagnosis
Dogs
Gadolinium DTPA*
Magnetic Resonance Imaging*
Methylene Blue
Myocardial Ischemia
Myocardium
Perfusion*
Potassium Chloride
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed
Tomography, Emission-Computed, Single-Photon
Adenosine
Gadolinium DTPA
Methylene Blue
Potassium Chloride
Technetium Tc 99m Sestamibi