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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2010 | Review

Quantification of myocardial perfusion by cardiovascular magnetic resonance

Author: Michael Jerosch-Herold

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2010

Abstract

The potential of contrast-enhanced cardiovascular magnetic resonance (CMR) for a quantitative assessment of myocardial perfusion has been explored for more than a decade now, with encouraging results from comparisons with accepted "gold standards", such as microspheres used in the physiology laboratory. This has generated an increasing interest in the requirements and methodological approaches for the non-invasive quantification of myocardial blood flow by CMR. This review provides a synopsis of the current status of the field, and introduces the reader to the technical aspects of perfusion quantification by CMR. The field has reached a stage, where quantification of myocardial perfusion is no longer a claim exclusive to nuclear imaging techniques. CMR may in fact offer important advantages like the absence of ionizing radiation, high spatial resolution, and an unmatched versatility to combine the interrogation of the perfusion status with a comprehensive tissue characterization. Further progress will depend on successful dissemination of the techniques for perfusion quantification among the CMR community.

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Zhang H, Shea SM, Park V, Li D, Woodard PK, Gropler RJ, Zheng J: Accurate myocardial T1 measurements: toward quantification of myocardial blood flow with arterial spin labeling. Magn Reson Med. 2005, 53: 1135-42. 10.1002/mrm.20461.CrossRefPubMed

Wright KB, Klocke FJ, Deshpande VS, Zheng J, Harris KR, Tang R, Finn JP, Li D: Assessment of regional differences in myocardial blood flow using T2-weighted 3D BOLD imaging. Magn Reson Med. 2001, 46: 573-8. 10.1002/mrm.1229.CrossRefPubMed

Dharmakumar R, Arumana JM, Larson AC, Chung Y, Wright GA, Li D: Cardiac phase-resolved blood oxygen-sensitive steady-state free precession MRI for evaluating the functional significance of coronary artery stenosis. Invest Radiol. 2007, 42: 180-8. 10.1097/01.rli.0000254407.26068.54.CrossRefPubMed

Zhang H, Gropler RJ, Li D, Zheng J: Assessment of myocardial oxygen extraction fraction and perfusion reserve with BOLD imaging in a canine model with coronary artery stenosis. J Magn Reson Imaging. 2007, 26: 72-9. 10.1002/jmri.20964.CrossRefPubMed

Johansson E, Olsson LE, Mansson S, Petersson JS, Golman K, Stahlberg F, Wirestam R: Perfusion assessment with bolus differentiation: a technique applicable to hyperpolarized tracers. Magn Reson Med. 2004, 52: 1043-51. 10.1002/mrm.20247.CrossRefPubMed

Gerber BL, Raman SV, Nayak K, Epstein FH, Ferreira P, Axel L, Kraitchman DL: Myocardial first-pass perfusion cardiovascular magnetic resonance: history, theory, and current state of the art. J Cardiovasc Magn Reson. 2008, 10: 18-10.1186/1532-429X-10-18.PubMedCentralCrossRefPubMed

Utz W, Niendorf T, Wassmuth R, Messroghli D, Dietz R, Schulz-Menger J: Contrast-dose relation in first-pass myocardial MR perfusion imaging. J Magn Reson Imaging. 2007, 25: 1131-5. 10.1002/jmri.20910.CrossRefPubMed

Kim D, Axel L: Multislice, dual-imaging sequence for increasing the dynamic range of the contrast-enhanced blood signal and CNR of myocardial enhancement at 3T. J Magn Reson Imaging. 2006, 23: 81-6. 10.1002/jmri.20471.CrossRefPubMed

Gatehouse PD, Elkington AG, Ablitt NA, Yang GZ, Pennell DJ, Firmin DN: Accurate assessment of the arterial input function during high-dose myocardial perfusion cardiovascular magnetic resonance. J Magn Reson Imaging. 2004, 20: 39-45. 10.1002/jmri.20054.CrossRefPubMed

10.

Christian TF, Rettmann DW, Aletras AH, Liao SL, Taylor JL, Balaban RS, Arai AE: Absolute myocardial perfusion in canines measured by using dual-bolus first-pass MR imaging. Radiology. 2004, 232: 677-84. 10.1148/radiol.2323030573.CrossRefPubMed

11.

Hsu LY, Kellman P, Arai AE: Nonlinear myocardial signal intensity correction improves quantification of contrast-enhanced first-pass MR perfusion in humans. J Magn Reson Imaging. 2008, 27: 793-801. 10.1002/jmri.21286.CrossRefPubMed

12.

Cernicanu A, Axel L: Theory-based signal calibration with single-point T1 measurements for first-pass quantitative perfusion MRI studies. Acad Radiol. 2006, 13: 686-93. 10.1016/j.acra.2006.02.040.CrossRefPubMed

13.

Gebker R, Paetsch I, Neuss M, Schnackenburg B, Bornstedt A, Jahnke C, Gomaa O, Fleck E, Nagel E: Determinants of myocardial response in CMR perfusion imaging using Gd-BOPTA (Multihance). J Cardiovasc Magn Reson. 2005, 7: 565-72. 10.1081/JCMR-200060647.CrossRefPubMed

14.

Kim D, Gonen O, Oesingmann N, Axel L: Comparison of the effectiveness of saturation pulses in the heart at 3T. Magn Reson Med. 2008, 59: 209-15. 10.1002/mrm.21423.CrossRefPubMed

15.

Kremers FP, Hofman MB, Groothuis JG, Jerosch-Herold M, Beek AM, Zuehlsdorff S, Nielles-Vallespin S, van Rossum AC, Heethaar RM: Improved correction of spatial inhomogeneities of surface coils in quantitative analysis of first-pass myocardial perfusion imaging. J Magn Reson Imaging. 2010, 31: 227-33. 10.1002/jmri.21998.CrossRefPubMed

16.

Adluru G, McGann C, Speier P, Kholmovski EG, Shaaban A, Dibella EV: Acquisition and reconstruction of undersampled radial data for myocardial perfusion magnetic resonance imaging. J Magn Reson Imaging. 2009, 29: 466-73. 10.1002/jmri.21585.PubMedCentralCrossRefPubMed

17.

Wang Y, Moin K, Akinboboye O, Reichek N: Myocardial first pass perfusion: steady-state free precession versus spoiled gradient echo and segmented echo planar imaging. Magn Reson Med. 2005, 54: 1123-9. 10.1002/mrm.20700.CrossRefPubMed

18.

Hunold P, Maderwald S, Eggebrecht H, Vogt FM, Barkhausen J: Steady-state free precession sequences in myocardial first-pass perfusion MR imaging: comparison with TurboFLASH imaging. Eur Radiol. 2004, 14: 409-16. 10.1007/s00330-003-2176-1.CrossRefPubMed

19.

Schwitter J, Debatin JF, von Schulthess GK, McKinnon GC: Normal myocardial perfusion assessed with multishot echo-planar imaging. Magn Reson Med. 1997, 37: 140-7. 10.1002/mrm.1910370120.CrossRefPubMed

20.

Poncelet BP, Koelling TM, Schmidt CJ, Kwong KK, Reese TG, Ledden P, Kantor HL, Brady TJ, Weisskoff RM: Measurement of human myocardial perfusion by double-gated flow alternating inversion recovery EPI. Magn Reson Med. 1999, 41: 510-9. 10.1002/(SICI)1522-2594(199903)41:3<510::AID-MRM13>3.0.CO;2-G.CrossRefPubMed

21.

Panting JR, Gatehouse PD, Yang GZ, Jerosch-Herold M, Wilke N, Firmin DN, Pennell DJ: Echo-planar magnetic resonance myocardial perfusion imaging: parametric map analysis and comparison with thallium SPECT. J Magn Reson Imaging. 2001, 13: 192-200. 10.1002/1522-2586(200102)13:2<192::AID-JMRI1029>3.0.CO;2-N.CrossRefPubMed

22.

Ding S, Wolff SD, Epstein FH: Improved coverage in dynamic contrast-enhanced cardiac MRI using interleaved gradient-echo EPI. Magn Reson Med. 1998, 39: 514-9. 10.1002/mrm.1910390403.CrossRefPubMed

23.

Nayak KS, Cunningham CH, Santos JM, Pauly JM: Real-time cardiac MRI at 3 Tesla. Magn Reson Med. 2004, 51: 655-60. 10.1002/mrm.20053.CrossRefPubMed

24.

Brix G, Schad LR, Deimling M, Lorenz WJ: Fast and precise T1 imaging using a TOMROP sequence. Magn. Res. Imag. 1990, 8: 351-356.

25.

Nuyts H, Maes A, Vrolix M, Schiepers C, Schelbert H, Kuhle W, Bormans G, Poppe G, Buxton D, Suetens P, De Geest H, Mortelmans L: Three-dimensional correction for spillover and recovery of myocardial PET images. J Nucl Med. 1996, 37: 767-74.PubMed

26.

Kostler H, Ritter C, Reiss-Zimmermann M, Beer M, Hahn D, Sandstede J: Correction for partial volume errors in MR heart perfusion imaging. Magn Reson Med. 2004, 51: 848-52. 10.1002/mrm.20015.CrossRefPubMed

27.

Ferreira P, Gatehouse P, Kellman P, Bucciarelli-Ducci C, Firmin D: Variability of myocardial perfusion dark rim Gibbs artifacts due to sub-pixel shifts. J Cardiovasc Magn Reson. 2009, 11: 17-10.1186/1532-429X-11-17.PubMedCentralCrossRefPubMed

28.

Di Bella EV, Parker DL, Sinusas AJ: On the dark rim artifact in dynamic contrast-enhanced MRI myocardial perfusion studies. Magn Reson Med. 2005, 54: 1295-9. 10.1002/mrm.20666.PubMedCentralCrossRefPubMed

29.

Nagel E, Klein C, Paetsch I, Hettwer S, Schnackenburg B, Wegscheider K, Fleck E: Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease. Circulation. 2003, 108: 432-437. 10.1161/01.CIR.0000080915.35024.A9.CrossRefPubMed

30.

Klocke FJ, Simonetti OP, Judd RM, Kim RJ, Harris KR, Hedjbeli S, Fieno DS, Miller S, Chen V, Parker MA: Limits of detection of regional differences in vasodilated flow in viable myocardium by first-pass magnetic resonance perfusion imaging. Circulation. 2001, 104: 2412-6. 10.1161/hc4501.099306.CrossRefPubMed

31.

Jerosch-Herold M, Hu X, Murthy NS, Rickers C, Stillman AE: Magnetic resonance imaging of myocardial contrast enhancement with MS-325 and its relation to myocardial blood flow and the perfusion reserve. J Magn Reson Imaging. 2003, 18: 544-54. 10.1002/jmri.10384.CrossRefPubMed

32.

Klocke FJ: Measurements of coronary flow reserve: defining pathophysiology versus making decisions about patient care. Circulation. 1987, 76: 1183-1189.CrossRefPubMed

33.

Hoffman JI: Problems of coronary flow reserve. Ann Biomed Eng. 2000, 28: 884-96. 10.1114/1.1308503.CrossRefPubMed

34.

Kroll K, Wilke N, Jerosch-Herold M, Wang Y, Zhang Y, Bache RJ, Bassingthwaighte JB: Accuracy of modeling of regional myocardial flows from residue functions of an intravascular indicator. Am J Physiol (Heart Circ Physiol). 1996, 40: H1643-H1655.

35.

Jerosch-Herold M, Wilke N, Wang Y, Gong GR, Mansoor AM, Huang H, Gurchumelidze S, Stillman AE: Direct comparison of an intravascular and an extracellular contrast agent for quantification of myocardial perfusion. Int J Card Imaging. 1999, 15: 453-64. 10.1023/A:1006368619112.CrossRefPubMed

36.

Li X, Springer CS, Jerosch-Herold M: First-pass dynamic contrast-enhanced MRI with extravasating contrast reagent: evidence for human myocardial capillary recruitment in adenosine-induced hyperemia. NMR Biomed. 2009, 22: 148-57. 10.1002/nbm.1293.CrossRefPubMed

37.

Zierler KL: Equations for measuring blood flow by external monitoring of radioisotopes. Circulation Research. 1965, 16: 309-321.CrossRefPubMed

38.

Zierler K: Indicator dilution methods for measuring blood flow, volume, and other properties of biological systems: a brief history and memoir. Ann. Biomed. Eng. 2000, 28: 836-48.

39.

Bassingthwaigthe JB, Raymond GR, Chan JIS: Principles of tracer kinetics. Nuclear Cardiology: State of the Art and Future Directions. Edited by: Zaret BL, Beller GA. 1993, St. Louis: Mosby-Year Book, 3-23.

40.

Axel L: Tissue mean transit time from dynamic computed tomography by a simple deconvolution technique. Investigative Radiology. 1983, 18: 94-99. 10.1097/00004424-198301000-00018.CrossRefPubMed

41.

Jerosch-Herold M, Swingen C, Seethamraju RT: Myocardial blood flow quantification with MRI by model-independent deconvolution. Medical Physics. 2002, 29: 886-897. 10.1118/1.1473135.CrossRefPubMed

42.

Spencer RG, Fishbein KW: Measurement of spin-lattice relaxation times and concentrations in systems with chemical exchange using the one-pulse sequence: breakdown of the Ernst model for partial saturation in nuclear magnetic resonance spectroscopy. J Magn Reson. 2000, 142: 120-35. 10.1006/jmre.1999.1925.CrossRefPubMed

43.

Donahue KM, Weisskoff RM, Chesler DA, Kwong KK, Bogdanov AA, Mandeville JB, Rosen BR: Improving MR quantification of regional blood volume with intravascular T1 contrast agents: accuracy, precision, and water exchange. Magn Reson Med. 1996, 36: 858-67. 10.1002/mrm.1910360608.CrossRefPubMed

44.

Li X, Springer CS, Jerosch-Herold M: First-pass DCE-MRI with extravasating CR: Evidence for human myocardial capillary recruitment in adenosine-induced hyperemia. NMR in Biomedicine. 2008.

45.

Slavin GS, Wolff SD, Gupta SN, Foo TK: First-pass myocardial perfusion MR imaging with interleaved notched saturation: feasibility study. Radiology. 2001, 219: 258-63.CrossRefPubMed

46.

Ferreira P, Gatehouse P, Bucciarelli-Ducci C, Wage R, Firmin D: Measurement of myocardial frequency offsets during first pass of a gadolinium-based contrast agent in perfusion studies. Magn Reson Med. 2008, 60: 860-70. 10.1002/mrm.21723.CrossRefPubMed

47.

Plein S, Ryf S, Schwitter J, Radjenovic A, Boesiger P, Kozerke S: Dynamic contrast-enhanced myocardial perfusion MRI accelerated with k-t sense. Magn Reson Med. 2007, 58: 777-85. 10.1002/mrm.21381.CrossRefPubMed

48.

Gebker R, Jahnke C, Paetsch I, Schnackenburg B, Kozerke S, Bornstedt A, Fleck E, Nagel E: MR myocardial perfusion imaging with k-space and time broad-use linear acquisition speed-up technique: feasibility study. Radiology. 2007, 245: 863-71. 10.1148/radiol.2453061701.CrossRefPubMed

49.

Graafen D, Munnemann K, Weber S, Kreitner KF, Schreiber LM: Quantitative contrast-enhanced myocardial perfusion magnetic resonance imaging: simulation of bolus dispersion in constricted vessels. Med Phys. 2009, 36: 3099-106. 10.1118/1.3152867.CrossRefPubMed

Title: Quantification of myocardial perfusion by cardiovascular magnetic resonance
Author: Michael Jerosch-Herold
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2010
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/1532-429X-12-57

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