Endocardial and epicardial myocardial perfusion determined by semi-quantitative and quantitative myocardial perfusion magnetic resonance

Int J Cardiovasc Imaging. 2012 Aug;28(6):1499-511. doi: 10.1007/s10554-011-9982-3. Epub 2011 Nov 29.

Abstract

This study aims to quantify subendocardial and subepicardial myocardial blood flow (MBF) from dynamic contrast-enhanced MRI and to compare semi-quantitative and quantitative analysis methods. 17 healthy volunteers (9 males, mean age 34 ± 8) were scanned during adenosine stress and at rest. A "semi-quantitative" myocardial perfusion index (MPI) was calculated based on maximal upslopes of signal intensity-time profiles for a mid-ventricular myocardial slice. In addition, absolute MBF (ml/g/min) was estimated using Fermi-constrained deconvolution. On semi-quantitative analysis, the ratio of subendocardial to subepicardial MPI was 0.98 ± 0.1 at stress and 1.16 ± 0.09 at rest, P < 0.0001. The MPRI (i.e. the ratio of stress over rest MPI) for the subendocardium was 1.54 ± 0.3 versus 1.81 ± 0.35 for the subepicardium, P = 0.03. For quantitative analysis, the ratio of subendocardial to subepicardial MBF was 0.91 ± 0.11 at stress versus 1.17 ± 0.16 at rest, P < 0.0001. The subendocardial MBF reserve was also lower than in the subepicardium (2.6 ± 0.75 vs. 3.32 ± 0.93, P = 0.027). In conclusion, semi-quantitative and quantitative analysis of dynamic contrast-enhanced MRI shows higher subendocardial blood flow at rest and reduced subendocardial perfusion reserve compared to the subepicardium.

Publication types

  • Comparative Study

MeSH terms

  • Adenosine
  • Adult
  • Chi-Square Distribution
  • Contrast Media
  • Coronary Circulation*
  • Endocardium / physiology*
  • Female
  • Gadolinium DTPA
  • Hemodynamics
  • Humans
  • Magnetic Resonance Imaging, Cine*
  • Male
  • Myocardial Perfusion Imaging / methods*
  • Pericardium / physiology*
  • Predictive Value of Tests
  • Reference Values
  • Regional Blood Flow
  • Regression Analysis
  • Time Factors
  • Vasodilator Agents
  • Ventricular Function, Left

Substances

  • Contrast Media
  • Vasodilator Agents
  • Gadolinium DTPA
  • Adenosine