Department of Biomorphological and Functional Sciences, Institute of Biostructure and Bioimages of the National Council of Research, Federico II University of Naples, Naples, Italy
IRCCS Neuromed, Pozzilli, Isernia, Italy
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University of Naples, Naples, Italy
Dipartimento di Scienze Biomorfologiche e Funzionali, Universit Federico II, Via S. Pansini 5, I-80131 Napoli, Italy
SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy
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Johnson, P.C., Autoregulation of blood flow (1986) Circ Res, 59, pp. 483-49
Gibson, D.G., Prewitt, T.A., Brown, D.J., Analysis of left ventricular wall movement during isovolumic relaxation and its relation to coronary artery disease (1976) Br J Heart, 38, pp. 1010-1019
Gibson, D.G., Traill, T.A., Brown, D.J., Changes in left ventricular free wall thickness in patients with ischemic heart disease (1977) Br J Heart, 39, pp. 1312-1318
Upton, M.T., Rerych, S.K., Newman, G.E., Port, S., Cobb, F.R., Jones, R.H., Detecting abnormalities in left ventricular function during exercise before angina and ST-segment depression (1980) Circulation, 62, pp. 34l-9
Bonow, R.O., Bacharach, S.L., Green, M.V., Kent, K.M., Rosing, D.R., Lipson, L.C., Impaired left ventricular diastolic filling in patients with coronary artery disease: Assessment with radionuclide angiography (1981) Circulation, 64, pp. 315-323
Okada, R.D., Glover, D., Gaffney, T., Williams, S., Myocardial kinetics of technetium-99m hexakis-2methoxy-2-methylpropyl- isonitril (1988) Circulation, 77, pp. 491-498
Sinusas, A.J., Shi, Q., Saltzberg, M.T., Vitols, P., Jain, D., Wackers, F.J., Technetium-99m-tetrofosmin to assess myocardial blood flow: Experimental validation in an intact canine model of ischemia (1994) J Nucl Med, 35, pp. 664-671
Selwyn, A.P., Allan, R.M., L'Abbate, A., Horlock, P., Camici, P., Clark, J., Relation between regional myocardial uptake of rubidium-82 and perfusion: Absolute reduction of cation uptake in ischemia (1982) Am J Cardiol, 50, pp. 112-121
Schelbert, H.R., Phelps, M.E., Huang, S.C., MacDonald, N.S., Hansen, H., Selin, C., N-13 ammonia as an indicator of myocardial blood flow (1981) Circulation, 63, pp. 1259-1272
Bergmann, S.R., Fox, K.A., Rand, A.L., McElvany, K.D., Welch, M.J., Markham, J., Quantification of regional myocardial blood flow in vivo with 0-15 water (1984) Circulation, 70, pp. 724-733
Diamond, G.A., Forrester, J.S., Analysis of probability as an aid in the clinical diagnosis of coronary artery disease (1979) N Engl J Med, 300, pp. 1350-1358
Diamond, G.A., Staniloff, H.M., Forrester, J.S., Pollock, B.H., Swan, H.J., Computer-assisted diagnosis in the noninvasive evaluation of patients with suspected coronary artery disease (1983) J Am Coll Cardiol, 50, pp. 444-455
Gibbons, R.J., Chatterjee, K., Daley, J., Douglas, J.S., Fihn, S.D., Gardin, J.M., ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/America n Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina) (1999) J Am Coll Cardiol, 33, pp. 2092-2197
Cannon, P.J., Dell, R.B., Dwyer Jr., E.M., Regional myocardial perfusion rates in patients with coronary artery disease (1972) J Clin Invest, 51, pp. 978-994
DePasquale, E.E., Nody, A.C., DePuey, E.G., Garcia, E.V., Pilcher, G., Bredlau, C., Quantitative rotational thallium-201 tomography for identifying and localizing coronary artery disease (1988) Circulation, 77, pp. 3l6-27
Varma, S.K., Watson, D.D., Beller, G.A., Quantitative comparison of thallium-201 scintigraphy after exercise and dipyridamole in coronary artery disease (1989) Am J Cardiol, 64, pp. 871-877
Mahmarian, J.J., Boyce, T.M., Goldberg, R.K., Cocanougher, M.K., Roberts, R., Verani, M.S., Quantitative exercise thallium-201 single photon emission computed tomography for the enhanced diagnosis of ischemic heart disease (1990) J Am Coll Cardiol, 15, pp. 318-329
Berman, D.S., Kiat, H., Friedman, J.D., Wang, F.P., Van Train, K., Matzer, L., Separate acquisition rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: A clinical validation study (1993) J Am Coll Cardiol, 22, pp. l455-64
Van Train, K.F., Areeda, J., Garcia, E.V., Cooke, C.D., Maddahi, J., Kiat, H., Quantitative same-day rest-stress technetium-99m-sestamibi SPECT: Definition and validation of stress normal limits and criteria for abnormality (1993) J Nucl Med, 34, pp. 1494-1502
Iskandrian, A.S., Heo, J., Nguyen, T., Beer, S.G., Cave, V., Ogilby, J.D., Assessment of coronary artery disease using single-photon emission computed tomography with thallium-201 during adenosine-induced coronary hyperemia (1991) Am J Cardiol, 67, pp. 1190-1194
Amanullah, A.M., Berman, D.S., Kiat, H., Friedman, J.D., Usefulness of hemodynamic changes during adenosine infusion in predicting the diagnostic accuracy of adenosine technetium-99m sestamibi single-photon emission computed tomography (SPECT) (1997) Am J Cardiol, 79, pp. 1319-1322
Little, W.C., Constantinescu, M., Applegate, R.J., Kutcher, M.A., Burrows, M.T., Kahl, F.R., Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? (1988) Circulation, 78, pp. 1157-1166
Ambrose, J.A., Tannenbaum, M.A., Alexopoulos, D., Hjemdahl-Monsen, C.E., Leavy, J., Weiss, M., Angiographie progression of coronary artery disease and the development of myocardial infarction (1988) J Am Coll Cardiol, 12, pp. 56-102
Iskandrian, A.S., Chae, S.C., Heo, J., Stanberry, C.D., Wasserleben, V., Cave, V., Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease (1993) J Am Coll Cardiol, 22, pp. 665-670
Schelbert, H.R., Wisenberg, G., Phelps, M.E., Gould, K.L., Henze, E., Hoffman, E.J., Noninvasive assessment of coronary stenosis by myocardial imaging during pharmacological coronary vasodilation. VI. Detection of coronary artery disease in human beings with intravenous N-13 ammonia and positron computed tomography (1982) Am J Cardiol, 49, pp. 1197-1207
Go, R.T., Marwick, T.H., MacIntyre, W.J., Saha, G.B., Neumann, D.R., Underwood, D.A., A prospective comparison of rubidium-82 PET and thallium-201 SPECT myocardial perfusion imaging utilizing a single dipyridamole stress in the diagnosis of coronary artery disease (1990) J Nucl Med, 31, pp. 1899-1905
Ritchie, J.L., Bateman, T.M., Bonow, R.O., Crawford, M.H., Gibbons, R.J., Hall, R.J., Guidelines for clinical use of cardiac radionuclide imaging. Report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Radionuclide Imaging), developed in collaboration with the American Society of Nuclear Cardiology (1995) J Am Coll Cardiol, 25, pp. 521-547
Cerqueira, M.D., Verani, M.S., Schwaiger, M., Heo, J., Iskandrian, A.S., Safety profile of adenosine stress perfusion imaging: Results from the Adenoscan multicenter trial registry (1994) J Am Coll Cardiol, 23, pp. 384-389
Porter, T.R., Xie, F., Transient myocardial contrast after initial exposure to diagnostic ultrasound pressure with minute doses of intravenously injected microbubbles: Demonstration and potential mechanisms (1995) Circulation, 92, pp. 2391-2395
Shaw, L.J., Gillam, L., Feinstein, S., Dent, J., Plotnick, G., Use of intravenous contrast agent (Optison) to enhance echocardiography: Efficacy and cost implication (1998) Am J Manag Care, 4, pp. SP169-SP176. , Optison multicenter Study Group
Nagueh, S.F., Vaduganathan, P., Ali, N., Blaustein, A., Verani, M.S., Winters Jr., W.L., Identification of hibernating myocardium: Comparative accuracy of myocardial contrast echocardiography, rest-redistribution thallium-201 tomography and dobutamine echocardiography (1997) J Am Coll Cardiol, 29, pp. 985-993
Meza, M.F., Kates, M.A., Barbee, R.W., Revall, S., Peny, B., Murgo, J.P., Combination of dobutamine and myocardial contrast echocardiography to differentiate postischemic from infarcted myocardium (1997) J Am Coll Cardiol, 29, pp. 974-984
Higgins, C.B., De Roos, A., (2002) Cardiovascular MRI-MRA, , Baltimore, MD: Lippincott Williams & Wilkins
Gatehouse, P.D., Firmin, D.N., The cardiovascular magnetic resonance machine: Hardware and software requirements (2000) Hertz, 25, pp. 317-330
Diesbourg, L.D., Prato, F.S., Wisenberg, G., Drost, D.J., Marshall, T.P., Carroll, S.E., Quantification of myocardial blood flow and extracellular volumes using a bolus injection of Gd-DTPA: Kinetic modeling in canine ischemic disease (1992) Magn Reson Med, 23, pp. 239-253
Vallee, J.P., Lazeyras, F., Kasuboski, L., Chatelain, P., Howarth, N., Righetti, A., Quantification of myocardial perfusion with FAST sequence and Gd bolus in patients with normal cardiac function (1999) J Magn Reson Imaging, 9, pp. 197-203
Panting, J.R., Gatehouse, P.D., Yang, G.Z., Jerosch-Herold, M., Wilke, N., Firmin, D.N., Echo-planar imaging magnetic resonance myocardial perfusion imaging: Parametric map analysis and comparison with thallium SPECT (2001) J Magn Reson Imaging, 13, pp. 192-200
Eichenberger, A.C., Schuiki, E., Kochli, V.D., Amann, F.W., Mc-Kinnon, G.C., Von Schulthess, G.K., Ischemic heart disease: Assessment with gadolinium-enhanced ultrafast MR imaging and dipyridamole stress (1994) J Magn Reson Imaging, 4, pp. 425-431
Walsh, E.G., Doyle, M., Lawson, M.A., Blackwell, G.G., Pohost, G.M., Multislice first-pass myocardial perfusion imaging on a conventional clinical scanner (1995) Magn Reson Med, 34, pp. 39-47
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The many ways to myocardial perfusion imaging
Myocardial perfusion imaging (MPI) is important for the management of patients with suspected or known coronary artery disease (CAD). Nuclear cardiology is the most widely used noninvasive approach for the assessment of myocardial perfusion. The available single-photon emission computed tomography (SPECT) flow agents are characterized by a rapid myocardial extraction and by a cardiac uptake proportional to blood flow. In addition, different positron emission tomography (PET) tracers may be used for the quantitative measurement of myocardial blood flow and coronary flow reserve. The decrease in blood flow, determined by coronary artery stenosis, produces myocardial ischemia leading to perfusion abnormalities detectable by SPECT or PET in the early phase of ischemia. Other imaging techniques, such as contrast echocardiography and magnetic resonance imaging (MRI) have been more recently proposed as alternative methods for the evaluation of myocardial perfusion. Although several technical aspects have to be better defined to use contrast echocardiography in clinical practice, this approach appears promising for the evaluation of myocardial perfusion. MRI has also been proposed for the assessment of myocardial perfusion by measuring the alteration of regional myocardial magnetic properties after the intravenous injection of contrast agents. Due to the high contrast and spatial resolution of the technique, MRI allows differentiating sub-endocardial and sub-epicardial perfusion, emerging as a potential alternative non-ionizing technique to evaluate myocardial perfusion. This review illustrates the noninvasive imaging modalities for the evaluation of myocardial perfusion, underlying advantages and disadvantages of each technique.
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