Multislice MR perfusion imaging and regional myocardial function analysis: complimentary findings in chronic myocardial ischemia.

Purpose: The purpose of this study is to assess the reliability of multislice MR perfusion imaging in comparison to regional wall function and nuclear medicine and to test different qualitative and quantitative parameters for perfusion assessment.

Material and methods: 15 patients with chronic myocardial ischemia underwent CINE and first-pass perfusion MR imaging. Functional myocardial imaging was performed using a segmented CINE FLASH sequence and systolic myocardial wall thickening was assessed after semiautomated segmentation. MR first-pass perfusion studies were performed using a multislice saturation recovery TurboFLASH sequence. Different parameters were calculated for assessment of hypoperfused segments and results of MR imaging compared to 99mTc-SestaMIBI SPECT.

Results: MR perfusion imaging showed a sensitivity of 72% and a specificity of 98%. In combination with MR CINE imaging and wall thickening analysis we calculated a sensitivity of 100% and a specificity of 93%. Qualitative and quantitative perfusion parameter analysis showed significant differences between normal and hypoperfused segments for the signal intensity increase (p < 0.001), the signal intensity upslope (p < 0.001) as well as for the myocardial mean transit time (p < 0.001).

Conclusion: The combination of systolic wall thickening analysis and myocardial perfusion can markedly improve the sensitivity of MRI in depiction of LV myocardial perfusion abnormalities. For assessment of hypoperfusion, different quantitative and qualitative parameters can be calculated showing significant differences between normal state and hypoperfusion.