Blood oxygen level dependent (BOLD) MRI: A novel technique for the detection of myocardial ischemia

M. Egred, Gordon David Waiter, A. Al-Mohammad, Scott Ian Kay Semple, Thomas William Redpath, S. Walton

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Blood oxygen level dependent (BOLD) T2* MRI detects signal variance within the myocardium based on changes in the deoxyhaemoglobin level following pharmacological stress, and it has the potential to identify areas of myocardial ischemia. The aim of the present study was to assess the utility of BOLD T2* MRI in the detection of myocardial ischemia in patients with an existing diagnosis of coronary artery disease.

Method: Twenty-one patients with established three-vessel coronary artery disease on coronary angiography underwent rest and dipyridamole stress MRI using a double breath-hold T2* weighted ECG gated sequence. Analysis was performed on multiple short-axis slices of the heart, projected as a bull's eye. The myocardium was divided into three coronary territories, yielding 63 territories in total. A signal change between rest and stress of more than +/- 4% was significant, implying a change in deoxyhaemoglobin concentration. A signal decrease or no changes denote the presence of ischemia, while a signal increase indicates no ischemia.

Results: All images were of sufficient quality for signal intensity analysis. In 12/63 territories (19%), a significant signal increase following stress was detected. A significant signal decrease was detected in 34/63 territories (54%), and in 17/63 territories (27%) there was a nonsignificant change. The presence of a perfusion defect was identified, therefore, in 51/63 (81%), based on the signal difference between rest and stress.

Conclusion: Changes in myocardial oxygen level appear to be detectable by BOLD T2* MRI without using contrast media. Further, larger comparative studies are required to evaluate the diagnostic and prognostic impact of this technique and to compare it to the gold standard methods for the detection of myocardial ischemia. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Original languageEnglish
Pages (from-to)551-555
Number of pages4
JournalEuropean Journal of Internal Medicine
Volume17
Issue number8
DOIs
Publication statusPublished - Dec 2006

Keywords

  • coronary artery disease
  • magnetic resonance imaging
  • blood oxygen level dependent (BOLD) MRI
  • myocardial ischemia
  • myocardial perfusion
  • imaging
  • dipyridamole
  • DIPYRIDAMOLE
  • MODEL
  • T-2

Cite this

Blood oxygen level dependent (BOLD) MRI: A novel technique for the detection of myocardial ischemia. / Egred, M.; Waiter, Gordon David; Al-Mohammad, A.; Semple, Scott Ian Kay; Redpath, Thomas William; Walton, S.

In: European Journal of Internal Medicine, Vol. 17, No. 8, 12.2006, p. 551-555.

Research output: Contribution to journalArticle

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abstract = "Background: Blood oxygen level dependent (BOLD) T2* MRI detects signal variance within the myocardium based on changes in the deoxyhaemoglobin level following pharmacological stress, and it has the potential to identify areas of myocardial ischemia. The aim of the present study was to assess the utility of BOLD T2* MRI in the detection of myocardial ischemia in patients with an existing diagnosis of coronary artery disease.Method: Twenty-one patients with established three-vessel coronary artery disease on coronary angiography underwent rest and dipyridamole stress MRI using a double breath-hold T2* weighted ECG gated sequence. Analysis was performed on multiple short-axis slices of the heart, projected as a bull's eye. The myocardium was divided into three coronary territories, yielding 63 territories in total. A signal change between rest and stress of more than +/- 4{\%} was significant, implying a change in deoxyhaemoglobin concentration. A signal decrease or no changes denote the presence of ischemia, while a signal increase indicates no ischemia.Results: All images were of sufficient quality for signal intensity analysis. In 12/63 territories (19{\%}), a significant signal increase following stress was detected. A significant signal decrease was detected in 34/63 territories (54{\%}), and in 17/63 territories (27{\%}) there was a nonsignificant change. The presence of a perfusion defect was identified, therefore, in 51/63 (81{\%}), based on the signal difference between rest and stress.Conclusion: Changes in myocardial oxygen level appear to be detectable by BOLD T2* MRI without using contrast media. Further, larger comparative studies are required to evaluate the diagnostic and prognostic impact of this technique and to compare it to the gold standard methods for the detection of myocardial ischemia. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.",
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T1 - Blood oxygen level dependent (BOLD) MRI: A novel technique for the detection of myocardial ischemia

AU - Egred, M.

AU - Waiter, Gordon David

AU - Al-Mohammad, A.

AU - Semple, Scott Ian Kay

AU - Redpath, Thomas William

AU - Walton, S.

PY - 2006/12

Y1 - 2006/12

N2 - Background: Blood oxygen level dependent (BOLD) T2* MRI detects signal variance within the myocardium based on changes in the deoxyhaemoglobin level following pharmacological stress, and it has the potential to identify areas of myocardial ischemia. The aim of the present study was to assess the utility of BOLD T2* MRI in the detection of myocardial ischemia in patients with an existing diagnosis of coronary artery disease.Method: Twenty-one patients with established three-vessel coronary artery disease on coronary angiography underwent rest and dipyridamole stress MRI using a double breath-hold T2* weighted ECG gated sequence. Analysis was performed on multiple short-axis slices of the heart, projected as a bull's eye. The myocardium was divided into three coronary territories, yielding 63 territories in total. A signal change between rest and stress of more than +/- 4% was significant, implying a change in deoxyhaemoglobin concentration. A signal decrease or no changes denote the presence of ischemia, while a signal increase indicates no ischemia.Results: All images were of sufficient quality for signal intensity analysis. In 12/63 territories (19%), a significant signal increase following stress was detected. A significant signal decrease was detected in 34/63 territories (54%), and in 17/63 territories (27%) there was a nonsignificant change. The presence of a perfusion defect was identified, therefore, in 51/63 (81%), based on the signal difference between rest and stress.Conclusion: Changes in myocardial oxygen level appear to be detectable by BOLD T2* MRI without using contrast media. Further, larger comparative studies are required to evaluate the diagnostic and prognostic impact of this technique and to compare it to the gold standard methods for the detection of myocardial ischemia. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

AB - Background: Blood oxygen level dependent (BOLD) T2* MRI detects signal variance within the myocardium based on changes in the deoxyhaemoglobin level following pharmacological stress, and it has the potential to identify areas of myocardial ischemia. The aim of the present study was to assess the utility of BOLD T2* MRI in the detection of myocardial ischemia in patients with an existing diagnosis of coronary artery disease.Method: Twenty-one patients with established three-vessel coronary artery disease on coronary angiography underwent rest and dipyridamole stress MRI using a double breath-hold T2* weighted ECG gated sequence. Analysis was performed on multiple short-axis slices of the heart, projected as a bull's eye. The myocardium was divided into three coronary territories, yielding 63 territories in total. A signal change between rest and stress of more than +/- 4% was significant, implying a change in deoxyhaemoglobin concentration. A signal decrease or no changes denote the presence of ischemia, while a signal increase indicates no ischemia.Results: All images were of sufficient quality for signal intensity analysis. In 12/63 territories (19%), a significant signal increase following stress was detected. A significant signal decrease was detected in 34/63 territories (54%), and in 17/63 territories (27%) there was a nonsignificant change. The presence of a perfusion defect was identified, therefore, in 51/63 (81%), based on the signal difference between rest and stress.Conclusion: Changes in myocardial oxygen level appear to be detectable by BOLD T2* MRI without using contrast media. Further, larger comparative studies are required to evaluate the diagnostic and prognostic impact of this technique and to compare it to the gold standard methods for the detection of myocardial ischemia. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

KW - coronary artery disease

KW - magnetic resonance imaging

KW - blood oxygen level dependent (BOLD) MRI

KW - myocardial ischemia

KW - myocardial perfusion

KW - imaging

KW - dipyridamole

KW - DIPYRIDAMOLE

KW - MODEL

KW - T-2

U2 - 10.1016/J.EJIM.2006.04.015

DO - 10.1016/J.EJIM.2006.04.015

M3 - Article

VL - 17

SP - 551

EP - 555

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

IS - 8

ER -