The value of stress perfusion cardiovascular magnetic resonance imaging for patients referred from the adult congenital heart disease clinic: 5-year experience at the Toronto General Hospital
Autor: | Felipe Soares Torres, Djeven P. Deva, S. Lucy Roche, Erwin Oechslin, Laura Jimenez-Juan, Rachel Wald, Andrew M. Crean |
---|---|
Rok vydání: | 2013 |
Předmět: |
Adult
Heart Defects Congenital Male medicine.medical_specialty Heart disease Perfusion Imaging Vasodilator Agents Population Myocardial Ischemia Ischemia Magnetic Resonance Imaging Cine Hospitals General Diagnosis Differential Internal medicine medicine Humans Infusions Intravenous education Retrospective Studies Ontario education.field_of_study medicine.diagnostic_test business.industry Reproducibility of Results Magnetic resonance imaging General Medicine equipment and supplies medicine.disease Dipyridamole Coronary arteries medicine.anatomical_structure Pediatrics Perinatology and Child Health Exercise Test Etiology Cardiology Female Radiology Cardiology and Cardiovascular Medicine business human activities Perfusion Follow-Up Studies medicine.drug |
Zdroj: | Cardiology in the Young. 24:822-830 |
ISSN: | 1467-1107 1047-9511 |
Popis: | Background: Vasodilator stress perfusion cardiovascular magnetic resonance imaging is a clinically useful tool for detection of clinically significant myocardial ischaemia in adults. We report our 5-year retrospective experience with perfusion cardiovascular magnetic resonance in a large, quarternary adult congenital heart disease centre. Methods: We reviewed all cases of perfusion cardiovascular magnetic resonance in patients referred from the adult congenital heart disease service. Dipyridamole stress perfusion cardiovascular magnetic resonance was undertaken on commercially available 1.5 and 3 T cardiovascular magnetic resonance scanners. Late gadolinium enhancement imaging was performed 8–10 minutes after completion of the rest perfusion sequence. Navigator whole-heart coronary magnetic resonance angiography was also performed where feasible. Results of stress cardiovascular magnetic resonance were correlated with complementary imaging studies, surgery, and clinical outcomes. Results: Over 5 years, we performed 34 stress perfusion cardiovascular magnetic resonance examinations (11 positive). In all, 84% of patients had further investigations for ischaemia in addition to cardiovascular magnetic resonance. Within a subgroup of 19 patients who had definitive alternative assessment of their coronary arteries, stress perfusion cardiovascular magnetic resonance demonstrated a sensitivity of 82% and specificity of 100%. Of the 34 studies, two were false negatives, in which the aetiology of ischaemia was extrinsic arterial compression rather than intrinsic coronary luminal narrowing. Coronary abnormalities were identified in 71% of cases who had coronary magnetic resonance angiography. Conclusion: Stress perfusion cardiovascular magnetic resonance is a useful and accurate tool for investigation of myocardial ischaemia in an adult congenital heart disease population with suspected non-atherosclerotic coronary abnormalities. |
Databáze: | OpenAIRE |
Externí odkaz: |