Identification of hemodynamically significant coronary artery stenoses by dipyridamole-magnetic resonance imaging and 99mTc-methoxyisobutyl-isonitrile-SPECT.

摘要: Magnetic resonance imaging (MRI) has been used in conjunction with dipyridamole induced wall motion abnormalities for the noninvasive detection of coronary artery disease (CAD). To assess clinical usefulness dipyridamole-MRI localization CAD and to evaluate relation between myocardial perfusion 33 patients severe (>70% diameter reduction) underwent MRI at rest after infusion (0.75 mg dipyridamole/kg over a period 10 minutes). All performed exercise stress testing 20 study group additionally had stress99mTc-methoxyisobutyl-isonitrile-SPECT (MIBI-SPECT). Two (6%) could not be evaluated due artifacts during MRI. Segmental corresponding short axis planes were related major arteries using standardized segmental pattern. Detection or defects by 2 blinded observers consensus was criterion grading segment normal pathologic. For CAD, gradings presumed territories. Stress-ECG pathologic 19/31 yielding sensitivity 61% angina present 68% (21/31) patients. Dipyridamole-MRI detected 84% (26/31 patients) all new also angina. subgroup MIBI-SPECT images, both 90% (18/20) agreed 55/60 (92%) There no significant differences respect sensitivities Dipyridamole-MRI/MIBI-SPECT individual stenoses 81%/78% left anterior descending, 80%/80% circumflex 92%/89% right stenoses. However, specificity (89%) RCA slightly better than (80%). regional proved highly sensitive parameter non-invasive CAD. The similarity results suggests close agreement functional parameters assessment hemodynamically utility this test is still limited high cost long times which may, however, overcome development shorter sequences.