Assessment of myocardial viability with delayed-enhancement MRI in coronary artery disease: A correlative study with coronary artery stenosis using digital subtraction angiography.

Abstract

The aim of the present study was to investigate the correlation between the degree of coronary artery stenosis determined by digital subtraction angiography (DSA) and infarcted segments detected by delayed enhancement magnetic resonance imaging (DE-MRI). DE-MRI and DSA were performed in 40 patients with coronary artery disease. The number of myocardial segments with infarction, the transmural extent of myocardial infarction, score of myocardial infarction by MRI, degree of coronary artery stenosis and Gensini score of the coronary artery were assessed. The correlation was analyzed using Spearman's rank correlation test. Among the 40 patients, 126 infarcted myocardial segments with a total score of 307 were found by DE-MRI; the total Gensini score for coronary artery stenosis was 587. It was observed that 81.74% of the infarcted segments were at sites with >50% coronary artery stenosis. The correlation coefficient between the Gensini score and myocardial infarction score was 0.786 (P<0.001), indicating a good correlation. However, 18.26% of myocardial infarction segments were found in patients with slight coronary artery stenosis (≤25%). A correlation was identified between DSA detected coronary artery stenosis and infarcted segments detected by DE-MRI; a higher transmural extent of myocardial infarction correlated with more severe stenosis of the coronary artery. The combined use of the two tools may facilitate accurate diagnosis.