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Background Conventional quantitative assessment of myocardial perfusion analyzes the temporal relation between the arterial input function and the myocardial signal intensity curves, thereby neglecting many of the spatial and temporal relations within the myocardial signal intensity curves. These relations can be described by calculating the perfusion gradient between the left ventricular (LV) epicardial endocardial layers and expressing indexes such as the persistence (seconds), and strength (mean gradient / circumferential extent) of the gradient. As myocardial ischaemia predominantly affects the endocardial myocardial layer due to its higher oxygen demand, transmural gradient indexes may be sensitive markers of ischaemia.

journal of cardiovascular magnetic resonance

High-resolution analysis of transmural myocardial perfusion gradients from first pass perfusion MR data. Diagnostic criteria for the detection of coronary artery disease