Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography
Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography
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DOI：
10.1007/s00330-010-1897-1
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发表时间：
2011-01-01
影响因子：
5.9
通讯作者：
Kim, Dong Hun
中科院分区：
文献类型：
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作者：
Ko, Sung Min;Choi, Jin Woo;Kim, Dong Hun
与负荷灌注磁共振成像 (SP-MRI) 和传统冠状动脉造影 (CCA) 相比，评估腺苷负荷双能计算机断层扫描 (DECT) 用于检测导致可逆性心肌灌注缺损 (PD) 的血流动力学显着狭窄的可行性和诊断准确性。对 50 名经双源 CT (DSCT) 检测出已知冠状动脉疾病 (CAD) 的患者进行了对比增强、负荷 DECT 和高能和低能 X 射线光谱的研究腺苷输注期间的设置。与静息 DSCT 灌注图像相比，使用颜色编码的碘图来评估心肌 PD。将根据应激 DECT/休息 DSCT 的可逆心肌 PD 与基于节段的 SP-MRI 和基于血管区域的 CCA 进行比较。总共分析了 41 名患者的 697 个心肌节段和 123 个血管区域。 38 名患者的 301 个节段和 72 个血管区域在应激 DECT 上显示出可逆的 PD。应力 DECT 在检测 SP-MRI 上看到的具有可逆 PD 的节段时具有 89% 的敏感性、78% 的特异性和 82% 的准确性 (n = 28)。与 CCA (n = 41) 相比，应激 DECT 在检测具有血流动力学相关 CAD 的可逆心肌 PD 的血管区域方面具有 89% 的敏感性、76% 的特异性和 83% 的准确性。腺苷应激 DECT 可以识别 CAD 患者应激性心肌 PD。
To evaluate the feasibility and diagnostic accuracy of adenosine-stress dual-energy computed tomography (DECT) for detecting haemodynamically significant stenosis causing reversible myocardial perfusion defect (PD) compared with stress perfusion magnetic resonance imaging (SP-MRI) and conventional coronary angiography (CCA).Fifty patients with known coronary artery disease (CAD) detected by dual-source CT (DSCT) were investigated by contrast-enhanced, stress DECT with high- and low-energy x-ray spectra settings during adenosine infusion. A colour-coded iodine map was used for evaluation of myocardial PDs compared with rest DSCT perfusion images. Reversible myocardial PDs according to the stress DECT/rest DSCT were compared with SP-MRI on a segmental basis and CCA on a vascular territorial basis.A total of 697 myocardial segments and 123 vascular territories of 41 patients were analysed. Three hundred one segments and 72 vascular territories in 38 patients showed reversible PDs on stress DECT. Stress DECT had 89% sensitivity, 78% specificity and 82% accuracy for detecting segments with reversible PDs seen on SP-MRI (n = 28). Compared with CCA (n = 41), stress DECT had 89% sensitivity, 76% specificity and 83% accuracy for the detection of vascular territories with reversible myocardial PDs that had haemodynamically relevant CAD.Adenosine stress DECT can identify stress-induced myocardial PD in patients with CAD.