Adenosine-stress dynamic myocardial volume perfusion imaging with second generation dual-source computed tomography: Concepts and first experiences.
Recent research suggests that multidetector-row CT may have potential as a standalone modality for integrative imaging of coronary heart disease, including the assessment of the myocardial blood supply. However, the technical prerequisites for volumetric, time-resolved imaging of the passage of a contrast medium bolus through the myocardium have only been met with latest generation wide-detector CT scanners. Second-generation dual-source CT enables performing electrocardiographic (ECG)-synchronized dynamic myocardial perfusion imaging by a dedicated "shuttle" mode. With this acquisition mode, image data can be acquired during contrast medium infusion at 2 alternating table positions with the table shuttling back and forth between the 2 positions covering a 73-mm anatomic volume. We applied this acquisition technique for detecting differences in perfusion patterns between healthy and diseased myocardium and for quantifying myocardial blood flow under adenosine stress in 3 patients with coronary heart disease. According to our initial experience, the addition of adenosine stress volumetric dynamic CT perfusion to a cardiac CT protocol comprising coronary artery calcium quantification, prospectively ECG-triggered coronary CT angiography, and delayed acquisition appears promising for the comprehensive assessment of coronary artery luminal integrity, cardiac function, perfusion, and viability with a single modality.
Bastarrika
Gorka
G
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA.
Ramos-Duran
Luis
L
Schoepf
U Joseph
UJ
Rosenblum
Michael A
MA
Abro
Joseph A
JA
Brothers
Robin L
RL
Zubieta
José L
JL
Chiaramida
Salvatore A
SA
Kang
Doo Kyoung
DK
D000241:Adenosine; D000368:Aged; D000465:Algorithms; D002306:Cardiac Volume; D003323:Coronary Aneurysm; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels; D005080:Exercise Test / Q000379:methods*; D005240:Feasibility Studies; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D006334:Heart Function Tests / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed / Q000379:methods*
D000241:Adenosine