Current Cardiovascular Imaging Reports

, Volume 5, Issue 2, pp 126–132 | Cite as

Multicenter Studies on Cardiac Magnetic Resonance Perfusion and Delayed Enhancement Imaging

Cardiac Magnetic Resonance (E Nagel, Section Editor)
First Online:
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Abstract

Perfusion and late gadolinium enhancement imaging sequences are commonly used in cardiac magnetic resonance imaging for the diagnosis of myocardial ischemia and infarction. The available literature has expanded from single-center studies to multiple multicenter studies that have established the clinical applicability of both imaging techniques in routine practice. In this article, these multicenter trials and their clinical implications are discussed, as well as the areas of interest that require further study.

Keywords

Magnetic resonance imaging Ischemia Perfusion Viability Coronary artery disease Myocardial infarction STEMI Multicenter 
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Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

  1. 1.
    American College of Cardiology Foundation Task Force on Expert Consensus Documents, Hundley WG, Bluemke DA, Finn JP, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol. 2010;55:2614–62.PubMedCrossRefGoogle Scholar
  2. 2.
    Kim RJ, Fieno DS, Parrish TB, et al. Relationship of MRI delayed contrast enhancement to irreversible injury, infarct age, and contractile function. Circulation. 1999;100:1992–2002.PubMedGoogle Scholar
  3. 3.
    Kim RJ, Wu E, Rafael A, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343:1445–53.PubMedCrossRefGoogle Scholar
  4. 4.
    Nandalur KR, Dwamena BA, Choudhri AF, Nandalur MR, Carlos RC. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. J Am Coll Cardiol. 2007;50:1343–53.PubMedCrossRefGoogle Scholar
  5. 5.
    Shah DJ, Kim HW, Kim RJ. Evaluation of ischemic heart disease. Heart Fail Clin 2009, 5:315-332, v.Google Scholar
  6. 6.
    •• Schwitter J, Wacker CM, van Rossum AC, et al. MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trial. Eur Heart J 2008, 29:480-489. This paper represents the largest multicenter, multivendor study of stress perfusion CMR and is further notable for its head-to-head comparison with SPECT imaging, with catheter coronary angiography as the reference standard. Google Scholar
  7. 7.
    • Bernhardt P, Spiess J, Levenson B, et al. Combined assessment of myocardial perfusion and late gadolinium enhancement in patients after percutaneous coronary intervention or bypass grafts: a multicenter study of an integrated cardiovascular magnetic resonance protocol. JACC Cardiovasc Imaging 2009, 2:1292-1300. This paper combines both DE and perfusion CMR to enhance diagnostic accuracy in the largest cohort of patients examined prospectively for coronary artery disease. Google Scholar
  8. 8.
    Kitagawa K, Sakuma H, Nagata M, et al. Diagnostic accuracy of stress myocardial perfusion MRI and late gadolinium-enhanced MRI for detecting flow-limiting coronary artery disease: a multicenter study. Eur Radiol. 2008;18:2808–16.PubMedCrossRefGoogle Scholar
  9. 9.
    Klem I, Greulich S, Heitner JF, et al. Value of cardiovascular magnetic resonance stress perfusion testing for the detection of coronary artery disease in women. JACC Cardiovasc Imaging. 2008;1:436–45.PubMedCrossRefGoogle Scholar
  10. 10.
    Klem I, Heitner JF, Shah DJ, et al. Improved detection of coronary artery disease by stress perfusion cardiovascular magnetic resonance with the use of delayed enhancement infarction imaging. J Am Coll Cardiol. 2006;47:1630–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Wolff SD, Schwitter J, Coulden R, et al. Myocardial first-pass perfusion magnetic resonance imaging: a multicenter dose-ranging study. Circulation. 2004;110:732–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Giang TH, Nanz D, Coulden R, et al. Detection of coronary artery disease by magnetic resonance myocardial perfusion imaging with various contrast medium doses: first European multi-centre experience. Eur Heart J. 2004;25:1657–65.PubMedCrossRefGoogle Scholar
  13. 13.
    Klein C, Nagel E, Gebker R, et al. Magnetic resonance adenosine perfusion imaging in patients after coronary artery bypass graft surgery. JACC Cardiovasc Imaging. 2009;2:437–45.PubMedCrossRefGoogle Scholar
  14. 14.
    Pellikka PA, Nagueh SF, Elhendy AA, Kuehl CA, Sawada SG. American Society of Echocardiography. American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. J Am Soc Echocardiogr. 2007;20:1021–41.PubMedCrossRefGoogle Scholar
  15. 15.
    •• Kim RJ, Albert TS, Wible JH, et al; Gadoversetamide Myocardial Infarction Imaging Investigators. Performance of delayed-enhancement magnetic resonance imaging with gadoversetamide contrast for the detection and assessment of myocardial infarction: an international, multicenter, double-blinded, randomized trial. Circulation 2008, 117:629-637. Contrast-enhanced DE CMR has been available since 1999. Nonetheless, this study is the first to discretely analyze the diagnostic ability of the technique in a large multicenter, multivendor format with application to both acute and chronic myocardial infarction. Google Scholar
  16. 16.
    Selvanayagam JB, Kardos A, Francis JM, et al. Value of delayed-enhancement cardiovascular magnetic resonance imaging in predicting myocardial viability after surgical revascularization. Circulation. 2004;110:1535–41.PubMedCrossRefGoogle Scholar
  17. 17.
    Beek AM, Kuhl HP, Bondarenko O, et al. Delayed contrast-enhanced magnetic resonance imaging for the prediction of regional functional improvement after acute myocardial infarction. J Am Coll Cardiol. 2003;42:895–901.PubMedCrossRefGoogle Scholar
  18. 18.
    Gutberlet M, Frohlich M, Mehl S, et al. Myocardial viability assessment in patients with highly impaired left ventricular function: comparison of delayed enhancement, dobutamine stress MRI, end-diastolic wall thickness, and TI201-SPECT with functional recovery after revascularization. Eur Radiol. 2005;15:872–80.PubMedCrossRefGoogle Scholar
  19. 19.
    Choi KM, Kim RJ, Gubernikoff G, Vargas JD, Parker M, Judd RM. Transmural extent of acute myocardial infarction predicts long-term improvement in contractile function. Circulation. 2001;104:1101–7.PubMedCrossRefGoogle Scholar
  20. 20.
    Gerber BL, Garot J, Bluemke DA, Wu KC, Lima JA. Accuracy of contrast-enhanced magnetic resonance imaging in predicting improvement of regional myocardial function in patients after acute myocardial infarction. Circulation. 2002;106:1083–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Ingkanisorn WP, Rhoads KL, Aletras AH, Kellman P, Arai AE. Gadolinium delayed enhancement cardiovascular magnetic resonance correlates with clinical measures of myocardial infarction. J Am Coll Cardiol. 2004;43:2253–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Masci PG, Francone M, Desmet W, et al. Right ventricular ischemic injury in patients with acute ST-segment elevation myocardial infarction: characterization with cardiovascular magnetic resonance. Circulation. 2010;122:1405–12.PubMedCrossRefGoogle Scholar
  23. 23.
    Roes SD, Kelle S, Kaandorp TA, et al. Comparison of myocardial infarct size assessed with contrast-enhanced magnetic resonance imaging and left ventricular function and volumes to predict mortality in patients with healed myocardial infarction. Am J Cardiol. 2007;100:930–6.PubMedCrossRefGoogle Scholar
  24. 24.
    Kwong RY, Chan AK, Brown KA, et al. Impact of unrecognized myocardial scar detected by cardiac magnetic resonance imaging on event-free survival in patients presenting with signs or symptoms of coronary artery disease. Circulation. 2006;113:2733–43.PubMedCrossRefGoogle Scholar
  25. 25.
    Kwong RY, Sattar H, Wu H, et al. Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction. Circulation. 2008;118:1011–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Kwon DH, Halley CM, Carrigan TP, et al. Extent of left ventricular scar predicts outcomes in ischemic cardiomyopathy patients with significantly reduced systolic function: a delayed hyperenhancement cardiac magnetic resonance study. JACC Cardiovasc Imaging. 2009;2:34–44.PubMedCrossRefGoogle Scholar
  27. 27.
    Cheong B, Muthupillai R, Wilson JM, et al. Prognostic significance of delayed enhancement magnetic resonance imaging: survival of 857 patients with and without left ventricular dysfunction. Circulation. 2009;120:2069–76.PubMedCrossRefGoogle Scholar
  28. 28.
    Klem I, Shah DJ, White RD, et al. Prognostic value of routine cardiac magnetic resonance assessment of left ventricular ejection fraction and myocardial damage: an international, multicenter study. Circ Cardiovasc Imaging. 2011;4:610–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Ingkanisorn WP, Kwong RY, Bohme NS, et al. Prognosis of negative adenosine stress magnetic resonance in patients presenting to an emergency department with chest pain. J Am Coll Cardiol. 2006;47:1427–32.PubMedCrossRefGoogle Scholar
  30. 30.
    Jahnke C, Nagel E, Gebker R, et al. Prognostic value of cardiac magnetic resonance stress tests: adenosine stress perfusion and dobutamine stress wall motion imaging. Circulation. 2007;115:1769–76.PubMedCrossRefGoogle Scholar
  31. 31.
    Steel K, Broderick R, Gandla V, et al. Complementary prognostic values of stress myocardial perfusion and late gadolinium enhancement imaging by cardiac magnetic resonance in patients with known or suspected coronary artery disease. Circulation. 2009;120:1390–400.PubMedCrossRefGoogle Scholar
  32. 32.
    Doesch C, Seeger A, Doering J, et al. Risk stratification by adenosine stress cardiac magnetic resonance in patients with coronary artery stenoses of intermediate angiographic severity. JACC Cardiovasc Imaging. 2009;2:424–33.PubMedCrossRefGoogle Scholar
  33. 33.
    Wellnhofer E, Olariu A, Klein C, et al. Magnetic resonance low-dose dobutamine test is superior to SCAR quantification for the prediction of functional recovery. Circulation. 2004;109:2172–4.PubMedCrossRefGoogle Scholar
  34. 34.
    Hundley WG, Morgan TM, Neagle CM, Hamilton CA, Rerkpattanapipat P, Link KM. Magnetic resonance imaging determination of cardiac prognosis. Circulation. 2002;106:2328–33.PubMedCrossRefGoogle Scholar
  35. 35.
    Raman SV, Dickerson JA, Jekic M, et al. Real-time cine and myocardial perfusion with treadmill exercise stress cardiovascular magnetic resonance in patients referred for stress SPECT. J Cardiovasc Magn Reson. 2010;12:41.PubMedCrossRefGoogle Scholar
  36. 36.
    Jekic M, Foster EL, Ballinger MR, Raman SV, Simonetti OP. Cardiac function and myocardial perfusion immediately following maximal treadmill exercise inside the MRI room. J Cardiovasc Magn Reson. 2008;10:3.PubMedCrossRefGoogle Scholar
  37. 37.
    Plein S, Schwitter J, Suerder D, Greenwood JP, Boesiger P, Kozerke S. k-Space and time sensitivity encoding-accelerated myocardial perfusion MR imaging at 3.0 T: comparison with 1.5 T. Radiology. 2008;249:493–500.PubMedCrossRefGoogle Scholar
  38. 38.
    Gebker R, Jahnke C, Paetsch I, et al. Diagnostic performance of myocardial perfusion MR at 3 T in patients with coronary artery disease. Radiology. 2008;247:57–63.PubMedCrossRefGoogle Scholar
  39. 39.
    Manka R, Jahnke C, Kozerke S, et al. Dynamic 3-dimensional stress cardiac magnetic resonance perfusion imaging: detection of coronary artery disease and volumetry of myocardial hypoenhancement before and after coronary stenting. J Am Coll Cardiol. 2011;57:437–44.PubMedCrossRefGoogle Scholar
  40. 40.
    Francone M, Bucciarelli-Ducci C, Carbone I, et al. Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction: insight from cardiovascular magnetic resonance. J Am Coll Cardiol. 2009;54:2145–53.PubMedCrossRefGoogle Scholar
  41. 41.
    Friedrich MG, Abdel-Aty H, Taylor A, Schulz-Menger J, Messroghli D, Dietz R. The salvaged area at risk in reperfused acute myocardial infarction as visualized by cardiovascular magnetic resonance. J Am Coll Cardiol. 2008;51:1581–7.PubMedCrossRefGoogle Scholar
  42. 42.
    Eitel I, Desch S, Fuernau G, et al. Prognostic significance and determinants of myocardial salvage assessed by cardiovascular magnetic resonance in acute reperfused myocardial infarction. J Am Coll Cardiol. 2010;55:2470–9.PubMedCrossRefGoogle Scholar
  43. 43.
    Hombach V, Grebe O, Merkle N, et al. Sequelae of acute myocardial infarction regarding cardiac structure and function and their prognostic significance as assessed by magnetic resonance imaging. Eur Heart J. 2005;26:549–57.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineNorth Shore HospitalAucklandNew Zealand
  2. 2.Imaging and Heart and Vascular InstitutesCleveland Clinic FoundationClevelandUSA

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