Validation of dynamic three-dimensional whole heart magnetic resonance myocardial perfusion imaging at 3.0 Tesla against fractional flow reserve for the detection of flow-limiting coronary heart disease

Abstract

Summary We demonstrate the feasibility of 3D myocardial perfusion CMR at 3 Tesla against fractional flow reserve (FFR) in 53 patients for the detection of flow-limiting coronary artery disease and show good agreement between the techniques. This technique shows excellent diagnostic sensitivity and specificity and may offer an alternative method of detecting ischaemia for the purpose of guiding revascularisation and risk stratification. Background Three-dimensional (3D) myocardial perfusion cardiovascular magnetic resonance (CMR) has recently been proposed to overcome the limited spatial coverage of conventional perfusion CMR methods1. The method has shown good diagnostic accuracy for the detection of coronary artery disease determined by quantitative coronary angiography (QCA)2. However the relationship between the severity of a coronary stenosis on QCA and its functional significance is variable. Pressure wirederived fractional flow reserve (FFR) <0.75 correlates closely with objective evidence of reversible ischemia and it has been demonstrated that ischaemia-guided PCI confers a prognostic benefit. Aim To determine the diagnostic accuracy of whole heart 3D myocardial perfusion CMR against invasively determined FFR.