Non-Ischemic Perfusion Defects due to Delayed Arrival of Contrast Material on Stress Perfusion Cardiac Magnetic Resonance Imaging after Coronary Artery Bypass Graft Surgery.
10.3348/kjr.2014.15.2.188
- Author:
Yeo Koon KIM
1
;
Eun Ah PARK
;
Sang Joon PARK
;
Gi Jeong CHEON
;
Whal LEE
;
Jin Wook CHUNG
;
Jae Hyung PARK
Author Information
1. Department of Radiology, Seoul National University Hospital, Seoul 110-744, Korea. iameuna1@gmail.com
- Publication Type:Case Reports
- Keywords:
Cardiac magnetic resonance imaging;
Stress perfusion test;
Coronary artery bypass graft;
Semiquantitative analysis
- MeSH:
Adenosine/diagnostic use;
Contrast Media/diagnostic use/*pharmacokinetics;
Coronary Angiography/*methods;
Coronary Artery Bypass/*methods;
Coronary Stenosis/*diagnosis;
Humans;
Magnetic Resonance Imaging/*methods;
Male;
Middle Aged;
Myocardial Perfusion Imaging/methods
- From:Korean Journal of Radiology
2014;15(2):188-194
- CountryRepublic of Korea
- Language:English
-
Abstract:
Herein we report about the adenosine stress perfusion MR imaging findings of a 50-year-old man who exhibited two different perfusion defects resulting from two different mechanisms after a coronary artery bypass surgery. An invasive coronary angiography confirmed that one perfusion defect at the mid-anterior wall resulted from an ischemia due to graft stenosis. However, no stenosis was detected on the graft responsible for the mid-inferior wall showing the other perfusion defect. It was assumed that the perfusion defect at the mid-inferior wall resulted from delayed perfusion owing to the long pathway of the bypass graft. The semiquantitative analysis of corrected signal-time curves supported our speculation, demonstrating that the rest-to-stress ratio index of the maximal slope of the myocardial territory in question was similar to those of normal myocardium, whereas that of myocardium with the stenotic graft showed a typical ischemic pattern. A delayed perfusion during long graft pathway in a post-bypass graft patient can mimick a true perfusion defect on myocardial stress MR imaging. Radiologists should be aware of this knowledge to avoid misinterpretation of graft and myocardial status in post bypass surgery patients.
