This cardiac multimodality study combines the use of metabolic 18F-FDG PET imaging with coronary angiography as well as DCE-MR perfusion imaging to investigate the relationship of myocardial metabolism and perfusion in chronic ischemia. A patient group with chronic total occlusion received exams pre- (PET/MRI+Angiography) as well as post- (MRI+Angiography) coronary intervention. Results showed a range of subtle to heavy resting perfusion deficits, with variable intra-patient relationships to metabolic deficits as indicated by 18F-FDG PET. Comparison of coronary angiography results with the corresponding quantitative perfusion analysis pre- and post-intervention suggest that resting perfusion is more sensitive to micro- than macrovascular coronary integrity.
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