2056 Quantitative magnetic resonance first-pass perfusion analysis in hypertrophic cardiomyopathy. Intrastudy variabilit

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Meeting abstract

2056 Quantitative magnetic resonance first-pass perfusion analysis in hypertrophic cardiomyopathy. Intrastudy variability Rory O'Hanlon*1, Chiara Bucciarelli-Ducci1, Agata Grasso1, Ali Alsafi2, Rick Wage1, Meghana Kulkarni1, Peter Gatehouse1, Michael Roughton2, Dudley J Pennell1 and Sanjay K Prasad1 Address: 1Royal Brompton Hospital, London, UK and 2Imperial College, London, UK * Corresponding author

from 11th Annual SCMR Scientific Sessions Los Angeles, CA, USA. 1–3 February 2008 Published: 22 October 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10(Suppl 1):A325

doi:10.1186/1532-429X-10-S1-A325

Abstracts of the 11th Annual SCMR Scientific Sessions - 2008

Meeting abstracts – A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/pdf/1532-429X-10-S1-info.pdf

This abstract is available from: http://jcmr-online.com/content/10/S1/A325 © 2008 O'Hanlon et al; licensee BioMed Central Ltd.

Aims Microvascular perfusion abnormalities in hypertrophic cardiomyopathy (HCM) are important markers of prognosis and may act as a trigger for arrhythmic events. Magnetic resonance first pass perfusion is a validated noninvasive imaging tool for the assessment of microvascular dysfunction by the quantification of myocardial perfusion reserve indices (MPRI). There are limited data available for the intrastudy and interstudy reproducibility of quantification using commercially available software. We sought to determine the intrastudy variability for MPRI in patients with HCM.

Methods We performed adenosine first-pass stress and rest perfusion on 26 patients with HCM on a 1.5 T Siemens Avanto scanner at our institution. A 3 slice hybrid-EPI sequence was used (TR 5.8 ms, 30°, ETL 4, 1860 Hz/ pixel,2.8 × 2.8 × 8 mm voxels over typically 360 × 270 mm FOV (adapted per patient) at TI = 110–140 ms after BIR-4 saturation for each of the 3 fat-suppressed slices per cycle, using TSENSE (R2, coil profiles average 8)). Gadolinium dose used for first-pass was 0.1 mmol/kg injected as a bolus at 7 mL/sec followed by a 15 mL saline flush through a power injector. In the 1st 50 ms of the perfusion scan, a low resolution FLASH image was acquired to determine the blood signal (arterial input function) in order to determine the MPRI. A single observer, blinded to patient clinical data, analyzed each perfusion study at two sepa-

rate time points to reduce bias. For perfusion analysis, the epi and endocardium was manually delineated and the myocardium was divided into 16 segments according to the ACC/AHA model. Each segment was subdivided into endocardial and epicardial segments and MPRI were calculated using customized software (CMRTools, Cardiovascular Imaging Solutions, London, UK).

Results Coefficients of variation were calculated as the standard deviation of the differences between the two measurements divided by the mean value, and comparison of values was calculated using a Bland-Altman plot (Figure 1). In total, 825 segme