title: 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.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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 (15-39%) and a severe (40-95%) 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 (2.31-2.81)mL/g/min (normal CBF) to 1.96 (1.83-2.33) mL/g/min (intermediate CBF-reduction) and to 1.55 (1.14-2.06)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).
  
  
  CONCLUSIONS
  Adenosine stress DSCT myocardial perfusion imaging allows quantification of regional MBF under various degrees of CBF reduction.
authors: Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors: Alexia
authors: A
authors: Rossi
authors: André
authors: A
authors: Uitterdijk
authors: Marcel
authors: M
authors: Dijkshoorn
authors: Ernst
authors: E
authors: Klotz
authors: Anoeshka
authors: A
authors: Dharampal
authors: Marcel
authors: M
authors: van Straten
authors: Wim J
authors: WJ
authors: van der Giessen
authors: Nico
authors: N
authors: Mollet
authors: Robert-Jan
authors: RJ
authors: van Geuns
authors: Gabriel P
authors: GP
authors: Krestin
authors: Dirk J
authors: DJ
authors: Duncker
authors: Pim J
authors: PJ
authors: de Feyter
authors: Daphne
authors: D
authors: Merkus
mesh_terms: D000241:Adenosine; D000818:Animals; D001783:Blood Flow Velocity; D017023:Coronary Angiography / Q000379:methods*; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000175:diagnosis*; D004195:Disease Models, Animal; D005080:Exercise Test / Q000379:methods; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D021621:Imaging, Three-Dimensional; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011897:Random Allocation; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D000241:Adenosine