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Quantification of Absolute Myocardial Blood Flow by Magnetic Resonance Perfusion Imaging

Feinberg Cardiovascular Research Institute, Department of Medicine and Division of Cardiology, Bluhm Cardiovascular Institute, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

^_* Reprint requests and correspondence: Dr. Daniel C. Lee, 303 East Chicago Avenue, Tarry 14-725, Chicago, Illinois 60611 (Email: dlee{at}northwestern.edu).

By serially imaging the myocardium during the initial transit of gadolinium contrast, magnetic resonance perfusion imaging can accurately assess relative reductions in regional myocardial blood flow and identify hemodynamically significant coronary artery disease. Models can be used to quantify myocardial blood flow (in milliliters/minute/gram) on the basis of dynamic signal changes within the myocardium and left ventricular cavity. Although the mathematical modeling involved in this type of analysis adds complexity, the benefits of absolute blood flow quantification might improve clinical diagnosis and have important implications for cardiovascular research.

Key Words: blood flow quantification • cardiac magnetic resonance • gadolinium • myocardial perfusion • quantitative modeling

Abbreviations and Acronyms   AMBF = absolute myocardial blood flow   CAC = coronary artery calcium score   CAD = coronary artery disease   CMR-PI = cardiac magnetic resonance perfusion imaging   FFR = fractional flow reserve   GdCA = gadolinium-based contrast agent   LGE = late gadolinium enhanced   LSI = linear, shift-invariant   LV = left ventricular   MPR = myocardial perfusion reserve   SNR = signal-to-noise ratio   TIC = time intensity curve