Dark-rim-free ungated first-pass perfusion CMR with 3-Slice end-systolic imaging: initial experience

Background First-pass perfusion (FPP) cardiac MR (CMR) imaging has been shown to have a high performance for diagnosis of coronary artery disease (CAD). Reliability of FPP imaging, however, is hindered by dark-rim artifacts (DRAs) and the need for near-perfect ECG gating. The latter can be challenging in the presence of arrhythmias or heart-rate variations during stress. Moreover, endsystolic (ES) imaging has recently been shown to provide improved visualization of subendocardial defects [1]. We developed an innovative ungated FPP technique capable of simultaneously eliminating DRAs [2,3] and enabling reconstruction of all slices at ES. We hypothesized that the developed method achieves DRA-free imaging and high accuracy in patients with suspected CAD, using nuclear myocardial perfusion imaging (MPI) as the reference.