Quantification of myocardial blood flow by adenosine-stress CT perfusion imaging in pigs during various degrees of stenosis correlates well with coronary artery blood flow and fractional flow reserve
Quantification of myocardial blood flow by adenosine-stress CT perfusion imaging in pigs during various degrees of stenosis correlates well with coronary artery blood flow and fractional flow reserve
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DOI：
10.1093/ehjci/jes150
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发表时间：
2013-04-01
影响因子：
6.2
通讯作者：
Merkus, Daphne
中科院分区：
文献类型：
--
作者：
Rossi, Alexia;Uitterdijk, Andre;Merkus, Daphne
只有少数初步的实验研究证明了腺苷负荷CT心肌灌注成像计算绝对心肌血流量（MBF）的可行性，从而提供冠状动脉狭窄是否是血流限制的信息。因此，我们的研究的目的是确定通过双源CT（DSCT）的腺苷负荷心肌灌注成像是否能够在具有不同程度的冠状动脉血流减少的动物模型中无创地定量局部MBF。在冠状动脉左前降支周围放置冠状动脉血流探头和可调液压封堵器，监测冠状动脉远端血流（CBF）同时引起了几个程度的冠状动脉血流减少。CT灌注（CT-MBF）是在腺苷负荷期间获得的，无CBF减少，中度（1539）和重度（4095）CBF减少。参考标准为CBF和血流储备分数测量值（FFR）。FFR同时来自远端冠状动脉压力和主动脉压力测量值。CT-MBF随着CBF降低严重程度的增加而进行性降低，从2.68（2.312.81）mL/g/min（正常CBF）至1.96（1.832.33）mL/g/min（中度CBF降低）和1.55（1.142.06）mL/g/min（重度CBF降低）（均P 0.001）。我们观察到CT-MBF与CBF（r 0.85，P 0.001）和CT-MBF与FFR（r 0.85，P 0.001）之间具有非常好的相关性。腺苷负荷DSCT心肌灌注成像可以在不同程度的CBF降低下定量局部MBF。
Only few preliminary experimental studies demonstrated the feasibility of adenosine stress CT myocardial perfusion imaging to calculate the absolute myocardial blood flow (MBF), thereby providing information whether a coronary stenosis is flow limiting. Therefore, the aim of our study was to determine whether adenosine stress myocardial perfusion imaging by Dual Source CT (DSCT) enables non-invasive quantification of regional MBF in an animal model with various degrees of coronary flow reduction.In seven pigs, a coronary flow probe and an adjustable hydraulic occluder were placed around the left anterior descending coronary artery to monitor the distal coronary artery blood flow (CBF) while several degrees of coronary flow reduction were induced. CT perfusion (CT-MBF) was acquired during adenosine stress with no CBF reduction, an intermediate (1539) and a severe (4095) CBF reduction. Reference standards were CBF and fractional flow reserve measurements (FFR). FFR was simultaneously derived from distal coronary artery pressure and aortic pressure measurements. CT-MBF decreased progressively with increasing CBF reduction severity from 2.68 (2.312.81)mL/g/min (normal CBF) to 1.96 (1.832.33) mL/g/min (intermediate CBF-reduction) and to 1.55 (1.142.06)mL/g/min (severe CBF-reduction) (both P 0.001). We observed very good correlations between CT-MBF and CBF (r 0.85, P 0.001) and CT-MBF and FFR (r 0.85, P 0.001).Adenosine stress DSCT myocardial perfusion imaging allows quantification of regional MBF under various degrees of CBF reduction.