A meta-analysis from pooled studies found that perfusion MRI heart function stress has a sensitivity of 89.1% and a specificity of 84.9% on a patient-based analysis using FFR as a reference, suggesting that stress perfusion MRI remains an accurate test for the detection of flow-limiting stenosis in patients with suspected or established CAD [6]. Another meta-analysis of 37 studies, including 2,191 patients with high CAD prevalence, stress CMR, using either wall motion abnormality or perfusion abnormality technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD: stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 and specificity of 0.86 on a patient level (disease prevalence = 70.5%). Stress perfusion imaging demonstrated a sensitivity of 0.91 and specificity of 0.81 on a patient level (disease prevalence = 57.4%) [51]. In patients with known or suspected CAD, the presence of late gadolinium enhancement and stress perfusion defect plus abnormal wall motion are independent predictors of all hard cardiac events [52]. MRI Heart Function with Stress Without IV Contrast MRI heart function stress without IV contrast can provide assessment of ventricular function/wall motion abnormalities. A single-center prospective study of 884 patients with known (70%) or suspected (30%) CAD demonstrated that inducible LV wall motion abnormalities during dobutamine CMR predicts cardiac death and myocardial ischemia [46]. A single-center prospective study focusing on women with known or suspected CAD and variable clinical symptoms demonstrated that, similar to men, dobutamine CMR can identify cardiac risk in women with known or suspected IHD [47]. A single-center prospective study of 208 patients with suspected CAD has demonstrated a high accuracy for detecting wall motion abnormalities related to ischemia with 86.2% sensitivity and 85.7% specificity [53].
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. A meta-analysis from pooled studies found that perfusion MRI heart function stress has a sensitivity of 89.1% and a specificity of 84.9% on a patient-based analysis using FFR as a reference, suggesting that stress perfusion MRI remains an accurate test for the detection of flow-limiting stenosis in patients with suspected or established CAD [6]. Another meta-analysis of 37 studies, including 2,191 patients with high CAD prevalence, stress CMR, using either wall motion abnormality or perfusion abnormality technique, demonstrates overall good sensitivity and specificity for the diagnosis of CAD: stress-induced wall motion abnormalities imaging demonstrated a sensitivity of 0.83 and specificity of 0.86 on a patient level (disease prevalence = 70.5%). Stress perfusion imaging demonstrated a sensitivity of 0.91 and specificity of 0.81 on a patient level (disease prevalence = 57.4%) [51]. In patients with known or suspected CAD, the presence of late gadolinium enhancement and stress perfusion defect plus abnormal wall motion are independent predictors of all hard cardiac events [52]. MRI Heart Function with Stress Without IV Contrast MRI heart function stress without IV contrast can provide assessment of ventricular function/wall motion abnormalities. A single-center prospective study of 884 patients with known (70%) or suspected (30%) CAD demonstrated that inducible LV wall motion abnormalities during dobutamine CMR predicts cardiac death and myocardial ischemia [46]. A single-center prospective study focusing on women with known or suspected CAD and variable clinical symptoms demonstrated that, similar to men, dobutamine CMR can identify cardiac risk in women with known or suspected IHD [47]. A single-center prospective study of 208 patients with suspected CAD has demonstrated a high accuracy for detecting wall motion abnormalities related to ischemia with 86.2% sensitivity and 85.7% specificity [53].