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Circulation. 2000;101:2375-2381

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(Circulation. 2000;101:2375.)
© 2000 American Heart Association, Inc.


Clinical Investigation and Reports

Assessment of Coronary Arterial Restenosis With Phase-Contrast Magnetic Resonance Imaging Measurements of Coronary Flow Reserve

W. Gregory Hundley, MD; L. David Hillis, MD; Craig A. Hamilton, PhD; Robert J. Applegate, MD; David M. Herrington, MD, MHS; Geoffrey D. Clarke, PhD; Gregory A. Braden, MD; Mark S. Thomas, RN; Richard A. Lange, MD; Ronald M. Peshock, MD; Kerry M. Link, MD

From the Departments of Internal Medicine (Cardiology Section) (W.G.H., R.J.A., D.M.H., G.A.B., M.S.T.) and Radiology (W.G.H., C.A.H., K.M.L.), Wake Forest University Baptist Medical Center, Winston-Salem, NC; and the Departments of Internal Medicine (Cardiovascular Division) (L.D.H., R.A.L., R.M.P.) and Radiology (G.D.C., R.M.P.), University of Texas Southwestern Medical Center, Dallas, Tex.

Correspondence to W. Gregory Hundley, MD, Cardiology Section, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 75157-1045. E-mail ghundley{at}wfubmc.edu

Background—After successful percutaneous coronary arterial revascularization, 25% to 60% of subjects have restenosis, a recurrent coronary arterial narrowing at the site of the intervention. At present, restenosis is usually detected invasively with contrast coronary angiography. This study was performed to determine if phase-contrast MRI (PC-MRI) could be used to detect restenosis noninvasively in patients with recurrent chest pain after percutaneous revascularization.

Methods and Results—Seventeen patients (15 men, 2 women, age 36 to 77 years) with recurrent chest pain >3 months after successful percutaneous intervention underwent PC-MRI measurements of coronary artery flow reserve followed by assessments of stenosis severity with computer-assisted quantitative coronary angiography. The intervention was performed in the left anterior descending coronary artery in 15 patients, one of its diagonal branches in 2 patients, and the right coronary artery in 1 patient. A PC-MRI coronary flow reserve value <=2.0 was 100% and 82% sensitive and 89% and 100% specific for detecting a luminal diameter narrowing of >=70% and >=50%, respectively.

Conclusions—Assessments of coronary flow reserve with PC-MRI can be used to identify flow-limiting stenoses (luminal diameter narrowings >70%) in patients with recurrent chest pain in the months after a successful percutaneous intervention.


Key Words: magnetic resonance imaging • coronary disease • restenosis




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