Paper

Dual perfusion imaging with integrated positron emission tomography-magnetic resonance imaging for the detection of coronary microvascular dysfunction in patients with ischemia with no obstructive coronary artery disease: a study on myocardial perfusion imaging and T1 mapping.

New research · Nuclear Medicine
Quantitative imaging in medicine and surgery · 2mo
Cohort studyQuantitative imaging in medicine and surgery· Jul 2026

Dual perfusion imaging with integrated positron emission tomography-magnetic resonance imaging for the detection of coronary microvascular dysfunction in patients with ischemia with no obstructive coronary artery disease: a study on myocardial perfusion imaging and T1 mapping.

Runze Wen, Qiang Xie, Xueer Meng … Xuemei Wang
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Cardiovascular ImagingCohort studyDiagnosisQ2IF 2.5

Higher native T1 on MRI is linked to coronary microvascular dysfunction in ischemia with no obstructive coronary arteries

Dual perfusion imaging with integrated positron emission tomography-magnetic resonance imaging for the detection of coronary microvascular dysfunction in patients with ischemia with no obstructive coronary artery disease: a study on myocardial perfusion imaging and T1 mapping.

Runze Wen … Xuemei Wang
Quantitative imaging in medicine and surgery · Jul 2026 · Q2 in Radiology
Background

Coronary microvascular dysfunction (coronary microvascular dysfunction) is a common cause of ischemia with no obstructive coronary arteries (ischemia with no obstructive coronary arteries), a condition previously considered benign but now recognized to confer an increased risk of adverse cardiovascular events.

Purpose

The aim of this study was to compare the diagnostic performance of T1 mapping and myocardial perfusion reserve index (myocardial perfusion reserve index) in detecting coronary microvascular dysfunction in patients with ischemia with no obstructive coronary arteries, with positron emission tomography (positron emission tomography) serving as the reference standard.

Methods

Sixty-six patients with ischemia with no obstructive coronary arteries (mean age 55±9 years; 50% female) were prospectively enrolled from August 2024 to February 2026 and underwent an integrated 3.0-T positron emission tomography-magnetic resonance imaging (MRI) examination.

n = 28
Results

higher T1 signals microvascular dysfunction in ischemia with no obstructive coronary arteries

75%
Sensitivity
100%
Specificity
More results

Myocardial flow reserve was correlated with both native T1 (r=-0.513; P<0.001) and myocardial perfusion reserve index (r=0.577; P<0.001), which were identified as independent predictors of impaired myocardial flow reserve (P=0.015 and P=0.002, respectively).

More results

At a cutoff of 1,225 ms, native T1 yielded a sensitivity of 75%, a specificity of 100%, and an accuracy of 89.39%, while myocardial perfusion reserve index, at a cutoff <1.8, yielded a sensitivity of 75%, a specificity of 81.58%, and an accuracy of 78.79%.

“
Conclusion · 1 of 2

Native T1 and myocardial perfusion reserve index showed nonsignificant differences in their ability to detect coronary microvascular dysfunction, with consistent and complementary diagnostic value.

Conclusion · 2 of 2

As a contrast-free method, native T1 may serve as a potential initial screening option, particularly for patients with renal dysfunction.

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