Stress T1 mapping for the detection of obstructive coronary artery disease: a prospective diagnostic accuracy study

作者：Simran Shergill, Mohamed Elshibly, Anju Velvet, Aida Moafi, Rachel England, Kelly Parke, Joanne Wormleighton, David Adlam, Sandeep S Hothi, Peter Kellman, Alasdair McIntosh, Alex McConnachie, Andrew Ladwiniec, G P Mccann, J. Ranjit Arnold · 发表于：Journal of Cardiovascular Magnetic Resonance · 年份：2026 · DOI：10.1016/j.jocmr.2026.102701 · 被引用次数：1 · 研究领域：Cardiac Imaging and Diagnostics、Coronary Interventions and Diagnostics、Cardiovascular Function and Risk Factors

BACKGROUND: In the assessment of patients with suspected coronary artery disease (CAD), the diagnostic role of stress-perfusion cardiovascular magnetic resonance (CMR) is well established. However, its reliance on gadolinium-based contrast agents may restrict its application in certain populations. T1 mapping during vasodilatory stress has been proposed as a contrast-free alternative for detecting CAD. This study sought to compare the diagnostic accuracy of adenosine-stress T1 reactivity (ΔT1) with that of stress-perfusion CMR for identifying hemodynamically significant CAD. METHODS: Patients with suspected angina referred for diagnostic invasive coronary angiography underwent 3-Tesla CMR consisting of the following: (1) T1 mapping at rest and following intravenous adenosine using a modified Look-Locker inversion recovery sequence, (2) stress and rest perfusion, and (3) late-gadolinium enhancement. Significant CAD was defined invasively as fractional flow reserve ≤0.80 in epicardial vessels ≥2 mm diameter (or quantitative flow ratio ≤0.80 if unavailable). A ΔT1 vessel threshold (% increase in T1 from rest to stress) was derived from receiver operating characteristic analysis, using invasive coronary angiography as the reference standard. Stress-perfusion CMR was assessed qualitatively with CAD determined by the presence of ischemia and/or infarction, (A) per-vessel (as determined by two independent readers) and (B) per-patient (following consensus read). RESULTS: Of 121 prosp...