Comparison of dual to single contrast bolus magnetic resonance myocardial perfusion imaging for detection of significant coronary artery disease

Purpose:

To investigate the incremental diagnostic value of dual‐bolus over single‐contrast‐bolus first pass magnetic resonance myocardial perfusion imaging (MR‐MPI) for detection of significant coronary artery disease (CAD).

Materials and Methods:

Patients (n = 49) with suspected CAD underwent first pass adenosine stress and rest MR‐MPI and invasive coronary angiography (CA). Gadolinium diethylenetriamine pentaacetic acid (Gd‐DTPA) was injected with a prebolus (1 mL) and a large bolus (0.1 mmol/kg). For the single‐bolus technique, the arterial input function (AIF) was obtained from the large‐contrast bolus. For the dual‐bolus technique, the AIF was reconstructed from the prebolus. Absolute myocardial perfusion was calculated by Fermi‐model constrained deconvolution. Receiver operating characteristic (ROC) analysis was used to investigate diagnostic accuracy of MR myocardial perfusion imaging for detection of significant CAD on CA at vessel‐based analysis.

Results:

The area under the curve (AUC) of the minimal stress perfusion value for the detection of significant CAD using the single‐bolus and dual‐bolus technique was 0.85 ± 0.04 (95% confidence interval [CI], 0.77–0.93) and 0.77 ± 0.05 (95% CI, 0.67–0.86), respectively.

Conclusion:

In this study the dual‐bolus technique had no incremental diagnostic value over single‐bolus technique for detection of significant CAD with the used contrast concentrations. J. Magn. Reson. Imaging 2010;32:88–93. © 2010 Wiley‐Liss, Inc.