Published Online
on July 30, 2008

A more recent version of this article appeared on September 1, 2008

This Article Full Text (PDF) Data Supplement All Versions of this Article: 1/2/122    most recent CIRCIMAGING.108.779108v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gebker, R. Articles by Paetsch, I. Search for Related Content PubMed PubMed Citation Articles by Gebker, R. Articles by Paetsch, I. Related Collections CT and MRI Related Article

Original Article

Additional value of myocardial perfusion imaging during dobutamine stress magnetic resonance for the assessment of coronary artery disease

Rolf Gebker¹; Cosima Jahnke; Robert Manka; Ashraf Hamdan; Bernhard Schnackenburg; Eckart Fleck and Ingo Paetsch

German Heart Institute Berlin

¹ E-mail: gebker{at}dhzb.de

Background—Dobutamine stress magnetic resonance (DSMR) imaging has emerged as a valuable tool for the detection of inducible wall motion abnormalities (WMA). The role of perfusion imaging during DSMR is not well defined. We examined whether the addition of myocardial perfusion imaging during DSMR provides incremental benefit for the evaluation of coronary artery disease (CAD).

Methods and Results—DSMR was combined with perfusion imaging (DSMRP) in 455 consecutive patients who were scheduled for clinically indicated invasive coronary angiography. Perfusion images were acquired in three standard short axis views at rest and during maximum dobutamine-atropine stress. Wall motion and perfusion images were interpreted sequentially, blinded to other data. Significant (70%) stenoses were present in 285 patients on invasive coronary angiography. The use of DSMRP vs. DSMR increased sensitivity (91% vs. 85%, P=0.001), but not specificity (70% vs. 82%, P=0.001) resulting in identical overall diagnostic accuracy (84% vs. 84%, P=n.s.; Youden index 0.61 vs. 0.67). DSMRP enabled the correct diagnosis of CAD in an additional 13% of DSMR negative patients at the cost of 11% more false positive cases.

Conclusion—The addition of perfusion imaging during DSMR improves sensitivity for the diagnosis of CAD but does not enhance overall diagnostic accuracy due to a concomitant decrease in specificity.

Key Words: coronary disease • myocardium • perfusion • dobutamine • wall motion analysis

Related Article

Imaging the Physiology of the Ischemic Cascade: Are 2 Tools Better Than 1?

Raymond Y. Kwong
Circ Cardiovasc Imaging 2008 1: 92-93. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				E. L. Wallace, T. M. Morgan, T. F. Walsh, E. Dall'Armellina, W. Ntim, C. A. Hamilton, and W. G. Hundley Dobutamine cardiac magnetic resonance results predict cardiac prognosis in women with known or suspected ischemic heart disease. J. Am. Coll. Cardiol. Img., March 1, 2009; 2(3): 299 - 307. [Abstract] [Full Text] [PDF]

				R. Y. Kwong Imaging the Physiology of the Ischemic Cascade: Are 2 Tools Better Than 1? Circ Cardiovasc Imaging, September 1, 2008; 1(2): 92 - 93. [Full Text] [PDF]