Assesment of myocardial ischemia in coronary artery disease with cardiac MR perfusion survey: Comparing with results of catheter or CT angiography.

AIM:Aim of this study is to evaluate the efficacy of Cardiac MRI Perfusion Survey for diagnosis of coronary artery disease by comparing with results of Coronary CT Angiography or results of Catheter Coronary Angiography.MATERIAL AND METHODS:31 patients who have been applied to Cardiac MRI Perfusion survey and after that in one month to Coronary CT Angiography or Catheter Coronary Angiography was found between December 2009 and November 2010. Dynamic images perpendicular to the long axis of the left ventricle, 3 to 4 cross sections on the short axis were obtained containing the myocardial first pass of the contrast agent by using ?Balanced TFE? sequence on Cardiac MRI Perfusion examination (stress and rest). Intravenous infusion of adenosine was made as a vasodilatator agent on stress examination. As a contrast agent 0.08 mmol/kg gadobutrol was used. MRI perfusion images were evaluated by visual method. The results of Cardiac MRI Perfusion survey, Catheter Coronary Angiography or Coronary CT Angiography were compared for the all coronary artery territories and each artery territory. Mc Nemar test was used to evaluate difference of diagnosis and Kappa test was used to evaluate the harmony of the surveys.RESULTS:In the evaluation of 31 patients, the sensitivity of MRI perfusion survey for establishing 70% and more stenosis of coronary artery was 94,7% and the specificity was 83%, accuracy was 90.3%, positive predictive value was 90%, negative predictive value was 90.9%. There was no significant difference between angiography survey (coronary CT angiography or catheter coronary angiography) and MRI perfusion survey (p value> 0.05). There was good harmony between two surveys (? value is 0.79). In the evaluation according to coronary artery territories the sensitivity, specificity, accuracy, positive predictive and negative predictive value of MRI perfusion survey to detect 70% and more stenosis of LAD artery were respectively 94.4%, 84.6%, 90.3%, 89.4%, 91.6%, and for the CX artery and RCA were %100, %100, %100, %100 and %100.CONCLUSION:Cardiac MRI Perfusion Survey seems to be a strong alternative method to the Catheter Coronary Angiography which has been accepted as a gold standard in evaluation of coronary artery disease and in excluding coronary artery stenosis. We think that number of catheter coronary angiography which is an invasive survey may be decrease as this method will spread more.