Dipyridamole stress and rest transmural myocardial perfusion ratio evaluation by 64 detector-row computed tomography

Cury, Roberto Caldeira; Magalhães, Tiago Augusto; Paladino, Antonio Tito; Shiozaki, Afonso Akio; Perini, M.; Senra, Tiago; Lemos, Pedro A.; Cury, Ricardo C.; Rochitte, Carlos Eduardo

doi:10.1016/j.jcct.2011.10.012

Cited by 65 publications

(34 citation statements)

References 18 publications

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“…8,17,26,27 Cardiac CT is tolerated by more patients than cardiac MR, and scan times are typically 10–15 minutes for cardiac CT. An important issue for cardiac CT is radiation dose. 18 The method we have described is equivalent to adding an additional calcium scan to the overall cardiac CT acquisition.…”

Section: Discussionmentioning

confidence: 99%

3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: Assessment of interstitial myocardial fibrosis

Nacif

Liu

Yao

et al. 2013

Journal of Cardiovascular Computed Tomography

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Background Myocardial fibrosis leads to impaired cardiac function and events. Extracellular volume fraction (ECV) assessed with an iodinated contrast agent and measured by cardiac CT may be a useful noninvasive marker of fibrosis. Objective The purpose of this study was to develop and evaluate a 3-dimensional (3D) ECV calculation toolkit (ECVTK) for ECV determination by cardiac CT. Methods Twenty-four subjects (10 systolic heart failure, age, 60 ± 17 years; 5 diastolic failure, age 56 ± 20 years; 9 matched healthy subjects, age 59 ± 7 years) were evaluated. Cardiac CT examinations were done on a 320-multidetector CT scanner before and after 130 mL of iopamidol (Isovue-370; Bracco Diagnostics, Plainsboro, NJ, USA) was administered. A calcium score type sequence was performed before and 7 minutes after contrast with single gantry rotation during 1 breath hold and single cardiac phase acquisition. ECV was calculated as (ΔHUmyocardium/ΔHUblood) × (1 − Hct) where Hct is the hematocrit, and ΔHU is the change in Hounsfield unit attenuation = HUafter iodine − HUbefore iodine. Cardiac magnetic resonance imaging was performed to assess myocardial structure and function. Results Mean 3D ECV values were significantly higher in the subjects with systolic heart failure than in healthy subjects and subjects with diastolic heart failure (mean, 41% ± 6%, 33% ± 2%, and 35% ± 5%, respectively; P = 0.02). Interobserver and intraobserver agreements were excellent for myocardial, blood pool, and ECV (intraclass correlation coefficient, >0.90 for all). Higher 3D ECV by cardiac CT was associated with reduced systolic circumferential strain, greater end-diastolic and -systolic volumes, and lower ejection fraction (r = 0.70, r = 0.60, r = 0.73, and r = −0.68, respectively; all P < 0.001). Conclusion 3D ECV by cardiac CT can be performed with ECVTK. We demonstrated increased ECV in subjects with systolic heart failure compared with healthy subjects. Cardiac CT results also showed good correlation with important functional heart biomarkers, suggesting the potential for myocardial tissue characterization with the use of 3D ECV by cardiac CT. This trial is registered at www.ClinicalTrials.gov as NCT01160471.

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Section: Discussionmentioning

confidence: 99%

3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: Assessment of interstitial myocardial fibrosis

Nacif

Liu

Yao

et al. 2013

Journal of Cardiovascular Computed Tomography

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“…34 As a comparable quantifiable measure, the transmural perfusion ratio, which is the ratio between mean subendocardial and mean subepicardial attenuation, has shown good predictive value compared with SPECT and invasive angiography. 35,36 The attenuation of the ischemic myocardium is usually compared either with the remote myocardium or with the left ventricular cavity. Indices for transmural, subendocardial, and myocardial perfusion provided incremental diagnostic accuracy when using control group measurements as a standard.…”

Section: Single-energy First-pass Computed Tomographymentioning

confidence: 99%

“…Static single-energy studies showed high specificity and sensitivity for the detection of hemodynamically significant CAD compared with SPECT, SPECT/ICA, [35][36][37]42,[50][51][52][53][54][55][56] or CMR. 24 Vessel-based sensitivity and specificity range from 50% to 96% and 68% to 98%, respectively, whereas the PPV and NPV are from 55% to 94% and 79% to 98%, respectively (see Table 2).…”

Section: Limitationsmentioning

confidence: 99%

Beyond Stenosis Detection

Cecco

Varga-Szemes

Meinel

et al. 2015

Radiologic Clinics of North America

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“…Her bir miyokardiyal segment perfüzyon defektinin varlığı ve yokluğuna göre skorlanır ve eğer miyokardiyumun ≥%50'sini içeriyorsa transmüral, aksi halde nontransmüral olarak derecelendirilir. Transmüral perfüzyon oranının (TPO) değer-lendirildiği yarı otomatik kantitatif değerlendir-mede, miyokardiyumun spesifik bir segmentinin subendokardiyal atenüasyonu ile subepikardiyal alana kadar olan tam kat atenüasyonunun oranı hesaplanır [38]. Koroner arter darlıklarında, kanlanmanın en fazla etkilendiği alan subendokardiyal alan olup, iskemi ve enfarkt ilk olarak bu tabakadan başlar.…”

Section: Görüntü Incelenmesiunclassified

Miyokardiyal Perfüzyon ve Geç Kontrastlanma

Kiris¹,

Aribal²

2013

Trd Sem

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Dipyridamole stress and rest transmural myocardial perfusion ratio evaluation by 64 detector-row computed tomography

Cited by 65 publications

References 18 publications

3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: Assessment of interstitial myocardial fibrosis

3D left ventricular extracellular volume fraction by low-radiation dose cardiac CT: Assessment of interstitial myocardial fibrosis

Beyond Stenosis Detection

Miyokardiyal Perfüzyon ve Geç Kontrastlanma

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