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An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion
Örebro University, School of Health Sciences. Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.ORCID iD: 0000-0001-5740-3538
Department of Radiology, Ryhov County Hospital, Jönköping, Sweden; Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden; Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping, Sweden.
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2017 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 52-61Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo-echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference.

METHODS: Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study.

RESULTS: Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI).

CONCLUSION: GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

Place, publisher, year, edition, pages
Blackwell Publishing, 2017. Vol. 37, no 1, p. 52-61
Keywords [en]
Magnetic Resonance Imaging, cardiac imaging techniques, coronary heart disease, nuclear medicine, perfusion
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology; Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-72073DOI: 10.1111/cpf.12267ISI: 000390688200008PubMedID: 26147785Scopus ID: 2-s2.0-84936803283OAI: oai:DiVA.org:oru-72073DiVA, id: diva2:1285316
Funder
Futurum - Academy for Health and Care, Jönköping County Council, SwedenAvailable from: 2019-02-04 Created: 2019-02-04 Last updated: 2019-02-14Bibliographically approved

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