Global quantification of left ventricular myocardial perfusion at dynamic CT: feasibility in a multicenter patient population.
OBJECTIVE
The purpose of this study was to determine the feasibility of global quantitative measurements of left ventricular myocardial perfusion derived from stress dynamic CT myocardial perfusion imaging.


METHODS
The coronary CT angiographic and CT myocardial perfusion imaging datasets of 146 patients were visually evaluated for the presence of coronary artery stenosis and perfusion defects. For the quantitative analysis, volumes of interest were defined over the entire left ventricular myocardium to obtain global myocardial blood flow (MBF), myocardial blood volume (MBV), and volume transfer constant (K(trans)).


RESULTS
In patients without anatomically significant coronary stenosis or perfusion defects, the mean value of global MBF was 137.9 ± 28.8 mL/100 mL/min; MBV, 19.5 ± 2.3 mL/100 mL; and K(trans), 85.8 ± 15.2 mL/100 mL/min. In patients with perfusion defects in one, two, or three vessels, the mean global MBF values were 132.6 ± 29.2, 117.4 ± 4.9, and 92.5 ± 11.2 mL/100 mL/min; MBV, 17.9 ± 3.2, 16.1 ± 3.1, and 12.8 ± 1.7 mL/100 mL; and K(trans), 80.4 ± 12.9, 76.6 ± 13.8, and 72.6 ± 15.5 mL/100 mL/min. In patients with significant (> 50%) stenosis in one, two, or three vessels at coronary CT angiography, the mean global MBF values were 129.2 ± 28.3, 120.5 ± 24.2, and 119.4 ± 33.5 mL/100 mL/min; MBV, 17.8 ± 3.3, 17.2 ± 3.2, and 14.7 ± 4.1 mL/100 mL; and K(trans), 80.3 ± 12.9, 76.0 ± 14.7, and 77.6 ± 13.2 mL/100 mL/min.


CONCLUSIONS
Global quantitative assessment of left ventricular perfusion with stress dynamic CT myocardial perfusion imaging is feasible, and the findings correlate with the visual assessment of perfusion and the presence of coronary artery stenosis at coronary CT angiography. The potential clinical utility of this technique as a diagnostic tool for differentiating normal from globally reduced myocardial perfusion or as a prognostic marker merits further investigation.
1 Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, 25 Courtenay Dr, MSC 226, Charleston, SC 29425.
Felix G
FG
Meinel
Ullrich
U
Ebersberger
U Joseph
UJ
Schoepf
Gladys G
GG
Lo
Yeon Hyeon
YH
Choe
Yining
Y
Wang
Jordan A
JA
Maivelett
Aleksander W
AW
Krazinski
Roy P
RP
Marcus
Fabian
F
Bamberg
Carlo Nicola
CN
De Cecco
D000368:Aged; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
CT; coronary artery disease; myocardial perfusion; perfusion imaging