Performance of adenosine "stress-only" perfusion MRI in patients without a history of myocardial infarction: a clinical outcome study

被引:14
作者
Lubbers, Daniel D. [1 ]
Rijlaarsdam-Hermsen, Dorine [2 ]
Kuijpers, Dirkjan [1 ,3 ]
Kerkhof, Marjan [4 ]
Sijens, Paul E. [1 ]
van Dijkman, Paul R. M. [2 ]
Oudkerk, Matthijs [1 ]
机构
[1] Univ Groningen, Dept Radiol, Univ Med Ctr Groningen, Groningen, Netherlands
[2] Bronovo Hosp, Dept Cardiol, The Hague, Netherlands
[3] Bronovo Hosp, Dept Radiol, The Hague, Netherlands
[4] Univ Groningen, Dept Epidemiol, Univ Med Ctr Groningen, Groningen, Netherlands
关键词
Cardiac; MRI; Ischemia; Perfusion; CORONARY-ARTERY-DISEASE; CARDIOVASCULAR MAGNETIC-RESONANCE; FRACTIONAL FLOW RESERVE; DIAGNOSTIC PERFORMANCE; 1ST-PASS PERFUSION; PROGNOSTIC VALUE; ANGIOGRAPHY; HEART; PREDICTION; CARDIOLOGY;
D O I
10.1007/s10554-010-9775-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To assess the diagnostic value of adenosine "stress-only" myocardial perfusion MR for ischemia detection as an indicator for coronary angiography in patients without a prior myocardial infarction and a necessity to exclude ischemia. Adenosine perfusion MRI was performed at 1.5 T in 139 patients with a suspicion of ischemia and no prior myocardial infarction. After 3 min of adenosine infusion a perfusion sequence was started. Patients with a perfusion defect were referred to coronary angiography (CAG). Patients with a normal perfusion were enrolled in follow-up. Fourteen out of 139 patients (10.1%) had a perfusion defect indicative of ischemia. These patients underwent a coronary angiogram, which showed complete agreement with the perfusion images. 125 patients with a normal myocardial perfusion entered follow-up (median 672 days, range 333-1287 days). In the first year of follow-up one Major Adverse Coronary Event (MACE) occurred and one patient had new onset chest pain with a confirmed coronary stenosis. Reaching a negative predictive value for MACE of 99.2% and for any coronary event of 98.4%. At 2 year follow-up no additional MACE occurred. Sensitivity of adenosine perfusion MR for MACE is 93.3% and specificity and positive predictive value are 100%. Adenosine myocardial perfusion MR for the detection of myocardial ischemia in a "stress-only" protocol in patients without prior myocardial infarctions, has a high diagnostic accuracy. This fast examination can play an important role in the evaluation of patients without prior myocardial infarctions and a necessity to exclude ischemia.
引用
收藏
页码:109 / 115
页数:7
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