ROLE OF STRESS CARDIAC MRI IN THE EVALUATION OF SUSPECTED CORONARY ARTERY DISEASE.

Abstract

Background: Cardiovascular magnetic resonance (CMR) has emerged in recent years as an essential tool in the imaging of coronary artery disease(CAD) and its preclinical detection. Our study aims at describing CMR imaging features of CAD, including CINE and perfusion imaging. We performed Stress perfusion CMR with Methods: pharmacologic stress(Adenosine) in 26patients of suspected CAD with intermediate cardiac chest pain. Results: All patients showed maintained wall thickness.The mean wall thickness of LV was 7.3mm ± 0.6 SD. 5 (6.4%) coronary territories showed regional wall motion abnormality on CINE imaging. No patient had hyperintensity on T2/STIR images. 9 patients (34.6%)showed subendocardial perfusion defect in coronary distribution on stress imaging, without matched defect on rest perfusion or LGE on delayed imaging (reversible inducible ischemia). 17 patients (73.4%) showed no perfusion defect on stress imaging. Out of 26, only 15 patients underwent catheter coronary angiography (CCA). This included all the 9 patients with stress inducible perfusion defect, of which 7(78%) showed significant CAD (>70% stenosis) in the corresponding artery and 2(22%) showed no significant CAD and 6 patients without stress inducible perfusion defect of which 5(83%) patients showed no significant CAD and 1(17%) showed significant CAD. Using CCA as a gold standard, the sensitivity of stress perfusion CMR in our study was 87.5%, specificity was 71.4% and accuracy was 80%. Stress Perfusion CMR is a noninvasive technique capable of detecting obstructive C Conclusion: AD with excellent diagnostic accuracy. It has high sensitivity and moderate specificity for diagnosing significant obstructive CAD compared with CCA.