Background: Cardiac magnetic resonance perfusion imaging, also called stress CMR, is a noninvasive modality for assessing myocardial perfusion without ionizing radiation. The most common indication for perfusion imaging is the detection of a significant coronary artery lesion. According to the American Heart Association (AHA) recommendations, the left ventricle wall is divided into 17 segments assigned to specific coronary artery territories. (1) In light of the variability in the coronary artery blood supply to myocardial segments, we analysed the correspondence of the 17 left ventricular segments with each coronary artery by comparing the CMR perfusion imaging and coronary angiography results.

Patients and Methods: 17 patients with suspected coronary artery disease (CAD) underwent CMR perfusion imaging followed by invasive coronary angiography. CMR imaging was performed on a 1.5 T MR system (Siemens Magnetom Avanto, Germany) with a standardised acquisition protocol using an adenosine dose of 140 µg/kg/min for 3 min. The presence of a regional perfusion defect was assessed visually and compared with coronary angiographic images.

Results: Our results revealed that subjects with angiographically significant coronary artery lesions are six times more likely to have perfusion defects in the CMR study than are those without significant CAD (positive likelihood ratio; LR).

Conclusion: CMR perfusion imaging is commonly performed in University Hospital Centre Rijeka. Along with stress perfusion imaging, it provides information about the left ventricular function and viability, which may be very helpful to cardiologists and cardiac surgeons in treating patients with coronary heart disease. This study is in line with current trends in noninvasive imaging and highlights the diagnostic utility of CMR perfusion imaging in the detection of significant CAD.