Quantitative Myocardial Perfusion MR Imaging

Abstract

Myocardial perfusion can be assessed with dynamic cardiovascular magnetic resonance imaging (MRI) during the passage of contrast agent bolus. Myocardial perfusion MRI has been evaluated qualitatively or semi-quantitatively. However, fully-quantitative myocardial perfusion MRI permits more objective assessment of coronary artery disease and evaluation of diffuse microvascular disease. Advances in acquisition and image analysis of cardiac magnetic resonance have enabled absolute myocardial perfusion quantification, previously only achievable with positron emission tomography. Absolute quantification of myocardial blood flow (MBF) requires knowledge of the amount of contrast agent in the myocardial tissue and the arterial input function (AIF) driving the delivery of contrast agent. However, accurate quantification of MBF is challenging due to lack of linearity between the measured blood signal and high blood contrast concentration during first pass, because sequences for perfusion MRI have been developed to optimize the contrast between normal and ischemic myocardium. Saturation correction of AIF response curve is required for the perfusion quantification. This review article will discuss saturation correction of AIF for accurate MBF measurements in perfusion MRI.