Original Research

Strain-encoded cardiac MR during high-dose dobutamine stress testing: Comparison to cine imaging and to myocardial tagging

  1. Grigorios Korosoglou MD1,*,
  2. Simon Futterer MD1,
  3. Per M. Humpert MD1,
  4. Nina Riedle BS1,
  5. Dirk Lossnitzer MD1,
  6. Birgit Hoerig RN1,
  7. Henning Steen MD1,
  8. Evangelos Giannitsis MD1,
  9. Nael F. Osman MD2,
  10. Hugo A. Katus MD1

Article first published online: 22 APR 2009

DOI: 10.1002/jmri.21759

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 29, Issue 5, pages 1053–1061, May 2009

Additional Information

How to Cite

Korosoglou, G., Futterer, S., Humpert, P. M., Riedle, N., Lossnitzer, D., Hoerig, B., Steen, H., Giannitsis, E., Osman, N. F. and Katus, H. A. (2009), Strain-encoded cardiac MR during high-dose dobutamine stress testing: Comparison to cine imaging and to myocardial tagging. J. Magn. Reson. Imaging, 29: 1053–1061. doi: 10.1002/jmri.21759

Author Information

  1. 1

    University of Heidelberg, Department of Cardiology, Heidelberg, Germany

  2. 2

    Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland

*University of Heidelberg, Department of Cardiology, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany

Publication History

  1. Issue published online: 22 APR 2009
  2. Article first published online: 22 APR 2009
  3. Manuscript Accepted: 9 FEB 2009
  4. Manuscript Received: 13 OCT 2008

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Keywords:

  • myocardial strain response;
  • Strain-Encoded MR;
  • tagged CMR;
  • dobutamine stress;
  • inducible ischemia

Abstract

Purpose

To investigate regional strain response during high-dose dobutamine stress cardiac magnetic resonance imaging (DS-CMR) using myocardial tagging and Strain-Encoded MR (SENC).

Materials and Methods

Stress induced ischemia was assessed by wall motion analysis, by tagged CMR and by SENC in 65 patients with suspected or known CAD who underwent DS-CMR in a clinical 1.5 Tesla scanner. Coronary angiography deemed as the standard reference for the presence or absence of CAD (≥50% diameter stenosis) in all patients.

Results

SENC and conventional tagging detected abnormal strain response in six and five additional patients, respectively, who were missed by cine images and proved to have CAD by angiography (P < 0.05 for SENC versus cine, P = 0.06 for tagging versus cine and p = NS for SENC versus tagging). On a per-vessel level, wall motion analysis on cine images showed high specificity (95%) but moderate sensitivity (70%) for the detection of CAD. Tagging and SENC yielded significantly higher sensitivity of 81% and 89%, respectively (P < 0.05 for tagging and P < 0.01 for SENC versus wall motion analysis, and p = NS for SENC versus tagging), while specificity was equally high (96% and 94%, respectively, P = NS for all).

Conclusion

Both the direct color-coded visualization of strain on CMR images and the generation of additional visual markers within the myocardium with tagged CMR represent useful adjuncts for DS-CMR, which may provide incremental value for the detection of CAD in humans. J. Magn. Reson. Imaging 2009;29:1053–1061. © 2009 Wiley-Liss, Inc.

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