Myocardial perfusion reserve assessed by T2-prepared steady-state free precession blood oxygen level-dependent magnetic resonance imaging in comparison to fractional flow reserve.

Background: Blood oxygen level-dependent (BOLD) cardiac magnetic resonance imaging (CMR) has been shown to be able to detect myocardial perfusion differences. However, validation of BOLD CMR against fractional flow reserve (FFR) is lacking. The aim of our study was to analyze the potential diagnostic accuracy of BOLD CMR in comparison to invasively measured FFR, which served as gold standard for a hemodynamic significant coronary lesion.

Methods And Results: BOLD image was performed at rest and during adenosine infusion in a 1.5-T CMR scanner. Thirty-six patients were analyzed for relative BOLD signal intensity increase according to the 16-segment model. Invasive FFR measurements were performed in the 3 major coronary arteries during adenosine infusion in all patients. An FFR≤0.8 was regarded to indicate a significant coronary lesion. Relative BOLD signal intensity increase was significantly lower in myocardial segments supplied by coronary arteries with an FFR≤0.8 compared with segments with an FFR>0.8 (1.1±0.2 versus 1.5±0.2; P<0.0001). Sensitivity and specificity yielded 88.2% and 89.5%, respectively.

Conclusions: CMR BOLD imaging reliably detects hemodynamic significant coronary artery disease and is, thus, an alternative to contrast-enhanced perfusion studies.