MR perfusion measures coronary stenoses

Quantitative myocardial first-pass perfusion can distinguish coronary artery stenoses with a high degree of specificity and negative predictive value. The test offers an alternative to diagnostic catheterization to grade the severity of coronary artery disease, according to a presentation at the North American Society of Cardiac Imaging meeting.

Dr. Prasad M. Panse and colleagues at the University of Florida at Jacksonville studied 41 patients who underwent catheter angiography and MR first-pass perfusion. The sensitivity, specificity, PPV, and NPV for MR imaging to detect severe stenosis as determined visually from coronary angiograms were 67.6%, 90.1%, 56.5%, and 94.5%, respectively, for each sector. The low per-sector sensitivity was likely the result of microvascular disease, small-vessel disease in diabetic patients, subendocardial ischemia, or other cardiac risk factors. On a per-patient basis, sensitivity rose to 92%.