SCMR China: Perfusion & Ischemic Heart Disease Webinar-Perfusion & Ischemic Heart Disease

Video Transcription

Video Summary

The webinar featured Professor Han Yuqi discussing cardiac perfusion imaging, ischemic heart disease, and myocardial viability in cardiac MRI. He reviewed the main MRI tools used to evaluate ischemia, including cine imaging for function, delayed enhancement/LGE for infarction, T2/T1 mapping, and stress perfusion imaging. He explained how stress agents such as adenosine, ATP, dipyridamole, and regadenoson help reveal reduced blood flow, and how signal changes over time distinguish normal from ischemic or infarcted myocardium.<br /><br />Professor Han highlighted both qualitative and quantitative perfusion methods. Quantitative analysis, using techniques such as dual-sequence or dual-bolus approaches and myocardial blood flow calculation, can improve detection of multivessel disease and coronary microvascular dysfunction, especially when visual interpretation is uncertain. He also discussed common technical challenges, including motion correction, endocardial border definition, spatial resolution, and the importance of ensuring adequate vasodilator stress.<br /><br />A major portion of the talk focused on prognosis and viability assessment. He reviewed large studies showing that perfusion defects and LGE are powerful predictors of outcomes, and that MRI can outperform SPECT in diagnostic accuracy. He emphasized that LGE extent is crucial for predicting recovery after revascularization: myocardium with less than 50% transmural scar is more likely to recover, while more extensive enhancement suggests low viability. He concluded that CMR is valuable for personalized decision-making about revascularization and patient management.<br /><br />The session ended with a brief discussion and questions about quantitative technique, stress adequacy, spatial vs temporal resolution, and the future promise of native T1 mapping.

Keywords

cardiac perfusion imaging

ischemic heart disease

myocardial viability

cardiac MRI

stress perfusion imaging

late gadolinium enhancement

myocardial blood flow

adenosine stress

coronary microvascular dysfunction

revascularization prognosis