Importance of parametric mapping and deconvolution in analyzing magnetic resonance myocardial perfusion images

Aim: We sought to improve the clinical interpretation of first-pass myocardial magnetic resonance perfusion. Parametric analyses of the myocardial distribution of the contrast agent have been proposed. The objective of the present study was to compare the effectiveness of visual analysis and of a parametric approach in an animal model under acquisition conditions as close as possible to clinical reality. Method: Experiments were conducted in vivo with various kinds of pharmacological stimulation in normal pigs and in pigs with stenosis of the left circumflex coronary artery. First-pass MR images and parametric maps were first assessed by medical experts. MR parameters, the myocardial signal intensity variation Delta SI, ascending up-slope, and rMBF (blood flow calculated by fast discrete ARMA deconvolution) were then compared with blood flow measurements using radioactive microspheres. Results and Conclusions: Interobserver agreement was 57% and 81 % and accuracy 53% and 8 1 %, for visual and for parametric map analysis, respectively. For deconvolution parameters, a linear relationship y = 371 + 1.27x, r = 0.78 was obtained between rMBF calculated by ARMA and the radioactive microsphere blood flow. Moreover, the fast and robust parametric mapping of rMBF by the discrete ARMA method allows MR evaluation of myocardial perfusion independently of hemodynamic conditions.