End-systolic Myocardial Perfusion MRI Using a Hybrid 2D/3D Steady-State Acquisition Scheme: Towards Reliable Detection of Subendocardial Ischemia in Coronary Microvascular Dysfunction
Behzad Sharif1, Rohan Dharmakumar1, Daniel Berman2, Debiao Li1, and Noel Bairey Merz2
1Biomedical Imaging Research Institute, Dept of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States, 2Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
A significant portion of patients with ischemic heart disease suffer from coronary microvascular dysfunction. Despite intense interest and several recent advancements, reliable diagnosis of coronary microvascular dysfunction on the basis of stress first-pass perfusion (FPP) cardiac MRI is an ongoing challenge. We hypothesized that high-resolution systolic FPP imaging can detect diffuse vasodilator-induced subendocardial defects and transmural perfusion gradients consistent with microvascular dysfunction in a swine model of diet-induced diabetes with no obstructive disease. To this end, we developed, optimized, and tested a new high-resolution FPP method with hybrid 2D/3D excitation capable of imaging all myocardial slices at the end-systolic phase.
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