Analysis of myocardial perfusion MRI

Michael Jerosch-Herold, Ravi Teja Seethamraju, Cory M Swingen, Norbert M. Wilke, Arthur E. Stillman

Research output: Contribution to journalReview articlepeer-review

150 Scopus citations

Abstract

Rapid MR imaging (MRI) during the first pass of an injected tracer is used to assess myocardial perfusion with a spatial resolution of 2-3 mm, and to detect any regional impairments of myocardial blood flow (MBF) that may lead to ischemia. The spatial resolution is sufficient to detect flow reductions that are limited to the subendocardial layer. The capacity of the coronary system to increase MBF several-fold in response to vasodilation can be quantified by analysis of the myocardial contrast enhancement. The myocardial perfusion reserve (MPR) is a useful concept for quantifying the vasodilator response. The perfusion reserve can be estimated from the ratio of MBFs during vasodilation and at baseline, in units identical to those used for invasive measurements with labeled microspheres, or from dimensionless flow indices normalized by their value for autoregulated flow at rest. The perfusion reserve can be reduced as a result of a blunted hyperemic response and/or an abnormal resting blood flow. The absolute quantification of MBF removes uncertainties in the evaluation of the vasodilator response, and can be achieved without the use of complex tracer kinetic models; therefore, its application to clinical studies is feasible.

Original languageEnglish (US)
Pages (from-to)758-770
Number of pages13
JournalJournal of Magnetic Resonance Imaging
Volume19
Issue number6
DOIs
StatePublished - Jun 2004

Keywords

  • Coronary artery disease
  • Magnetic resonance imaging
  • Myocardial blood flow
  • Perfusion
  • Tracer kinetics

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