Qualitative and Quantitative Assessment of Adenosine Triphosphate Stress Whole-Heart Dynamic Myocardial Perfusion Imaging Using 256-Slice Computed Tomography |
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Authors: | Akira Kurata Naoto Kawaguchi Teruhito Kido Katsuji Inoue Jun Suzuki Akiyoshi Ogimoto Jun-ichi Funada Jitsuo Higaki Masao Miyagawa Mani Vembar Teruhito Mochizuki |
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Institution: | 1. Department of Diagnostic and Therapeutic Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.; 2. Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Ehime, Japan.; 3. Department of Cardiology, National Hospital Organization, Ehime National Hospital, Ehime, Japan.; 4. CT Clinical Science, Philips Healthcare, Cleveland, Ohio, United States of America.; University of Washington School of Medicine, United States of America, |
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Abstract: | BackgroundThe aim of this study was to investigate the correlation of the qualitative transmural extent of hypoperfusion areas (HPA) using stress dynamic whole-heart computed tomography perfusion (CTP) imaging by 256-slice CT with CTP-derived myocardial blood flow (MBF) for the estimation of the severity of coronary artery stenosis.Methods and ResultsEleven patients underwent adenosine triphosphate (0.16 mg/kg/min, 5 min) stress dynamic CTP by 256-slice CT (coverage: 8 cm, 0.27 s/rotation), and 9 of the 11 patients underwent coronary angiography (CAG). Stress dynamic CTP (whole–heart datasets over 30 consecutive heart beats in systole without spatial and temporal gaps) was acquired with prospective ECG gating (effective radiation dose: 10.4 mSv). The extent of HPAs was visually graded using a 3-point score (normal, subendocardial, transmural). MBF (ml/100g/min) was measured by deconvolution. Differences in MBF (mean ± standard error) according to HPA and CAG results were evaluated. In 27 regions (3 major coronary territories in 9 patients), 11 coronary stenoses (> 50% reduction in diameter) were observed. In 353 myocardial segments, HPA was significantly related to MBF (P < 0.05; normal 295 ± 94; subendocardial 186 ± 67; and transmural 80 ± 53). Coronary territory analysis revealed a significant relationship between coronary stenosis severity and MBF (P < 0.05; non-significant stenosis < 50%], 284 ± 97; moderate stenosis 50–70%], 184 ± 74; and severe stenosis > 70%], 119 ± 69).ConclusionThe qualitative transmural extent of HPA using stress whole-heart dynamic CTP imaging by 256-slice CT exhibits a good correlation with quantitative CTP-derived MBF and may aid in assessing the hemodynamic significance of coronary artery disease. |
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