Quantification of transmural perfusion gradients by high-resolution MR versus fractional flow reserve for the assessment of coronary artery stenosis

Background The subendocardial layer of the myocardium is more sensitive to ischaemia than the subepicaridal layer due to interactions between myocardial contraction and blood supply. The transmural perfusion gradients observed in coronary heart disease (CAD) can be visualised with high spatial resolution myocardial perfusion CMR. These gradients are characterised by the extent and intensity of the endoto epicardial redistribution and by its temporal persistence. The gradientogram method (Hautvast et al. MRM 2011) has been developed to assess and quantify these characteristics of transmural perfusion gradients. The aim of this study was to assess the diagnostic accuracy of the method versus fractional flow reserve (FFR) in patients with suspected CAD.