Correlation of stress adenosine perfusion magnetic resonance imaging with stress-rest 99mTc myocardial perfusion scintigraphy and coronary angiography in patients with previous coronary endovascular intervention

In this study we prospectively evaluated the performance of adenosine stress-rest perfusion MRI, MRI wall motion imaging, late gadolinium enhancement, whether used alone or in combination, and compared them to adenosine stres-rest 99mTc SPECT in detecting ischemic myocardial segments among symptomatic patients with previous coronary endovascular intervention, considering coronary angiography as the referance standart.Eighteen patients (4 women and 14 men) were enrolled in this study. All patients were examined first with MRI and than with SPECT, during the same day with the same adenosine injection. Coronary angiography examinations were performed within the following week. Image evaluations were made using the AHA 17 segment model, with the exclusion of the apex (segment 17), by means of visual scoring for each segment made by two radiologists. Statistical analysis were made considering angiography as the reference standart and a p value lesser than 0,05 to indicate a significant difference.The sensitivity, specifity, positive and negative predictive values, accuracy and kappa values of single and combined MRI data were significantly higher than those with SPECT in differentiating normal and pathologic coronary segments with significant stenosis on coronary angiography.Individual MRI techniques and their combination have higher sensitivity and accuracy than the more widely used SPECT, in diagnosing significant coronary artery stenosis in symptomatic patients with previous coronary endovascular treatment.