Imaging Perfusion Deficits in Ischemic Heart Disease with Susceptibility-Enhanced T2-Weighted MRI: Preliminary Human Studies

Aim: This feasibility study explores relative myocardial perfusion characterization with an investigational T2/T2∗ contrast agent. Methods: Dysprosium-DTPA bis (methylamide) was administered peripherally in six patients with thallium defects. Rest and stress multi-section, gated, T2-weighted images were acquired with a 1.5 T echo-planar imager. Change in transverse relaxation rate was calculated in four segments for each subject. Results: Magnetic resonance (MR) identified five of five instances of ischemia or infarction, at a dose of agent (0.25 mmol/kg) that was comparable to that currently used with clinically approved gadolinium agents. Injection at twice this dose resulted in saturation of the signal change, and the one ischemic segment corresponding to the higher dose was not identified by MR. MR was negative in two segments which, on final diagnosis, were determined to manifest thallium attenuation artifact. Conclusion: MR perfusion imaging with high susceptibility agents has the potential to characterize myocardial perfusion deficits.