Combined myocardial stress perfusion imaging and myocardial stress tagging for detection of coronary artery disease at 3
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BioMed Central
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Combined myocardial stress perfusion imaging and myocardial stress tagging for detection of coronary artery disease at 3 Tesla Daniel Thomas*†1, Katharina Strach†1, Carsten Meyer1, Claas P Naehle1, Sebastian Schaare1, Sven Wasmann2, Hans H Schild1 and Torsten Sommer1 Address: 1Department of Radiology, University of Bonn, Bonn, Germany and 2Department of Internal Medicine II, University of Bonn, Bonn, Germany Email: Daniel Thomas* - [email protected]; Katharina Strach - [email protected]; Carsten Meyer - [email protected]; Claas P Naehle - [email protected]; Sebastian Schaare - [email protected]; Sven Wasmann - [email protected]; Hans H Schild - [email protected]; Torsten Sommer - [email protected] * Corresponding author †Equal contributors
Published: 18 December 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10:59
doi:10.1186/1532-429X-10-59
Received: 2 July 2008 Accepted: 18 December 2008
This article is available from: http://www.jcmr-online.com/content/10/1/59 © 2008 Thomas et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Adenosine stress perfusion is very sensitive for detection of coronary artery disease (CAD), and yields good specificity. Standard adenosine cine imaging lacks high sensitivity, but is very specific. Myocardial tagging improves detection of wall motion abnormalities (WMAs). Perfusion and tagging cardiovascular magnetic resonance (CMR) both benefit from high field imaging (improved contrast to noise ratio and tag persistence). We investigated the diagnostic impact of a combined stress perfusion-tagging protocol for detection of CAD at 3 Tesla. Methods: Stress perfusion and tagging images were acquired in 3 identical short axis locations (slice thickness 8 mm, FOV 320–380 mm, matrix 2562). A positive finding at coronary angiography was defined as stenosis or flow limiting restenosis > 50% in native and graft vessels. A true positive CMR – finding was defined as ≥ 1 perfusion deficit or new WMA during adenosine-stress in angiographically corresponding regions. Results: We included 60 patients (males: 41, females: 19; 21 suspected, 39 known CAD). Myocardial tagging extended stress imaging by 1.5–3 min and was well tolerated by all patients. Sensitivity and specificity for detection of significant CAD by adenosine stress perfusion were 0.93 and 0.84, respectively. The sensitivity of adenosine stress tagging was less (0.64), while the specificity was very high (1.0). The combination of both stress perfusion and stress tagging did not increase sensitivity. Conclusion: The combined adenosine stress perfusion-tagging protocol delivers high sensitivity and specificity for detection
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