title: Differentiation of myocardial ischemia and infarction assessed by dynamic computed tomography perfusion imaging and comparison with cardiac magnetic resonance and single-photon emission computed tomography.
abstract: OBJECTIVE
  To evaluate the feasibility of myocardial blood flow (MBF) by computed tomography from dynamic CT perfusion (CTP) for detecting myocardial ischemia and infarction assessed by cardiac magnetic resonance (CMR) or single-photon emission computed tomography (SPECT).
  
  
  METHODS
  Fifty-three patients who underwent stress dynamic CTP and either SPECT (n = 25) or CMR (n = 28) were retrospectively selected. Normal and abnormal perfused myocardium (ischemia/infarction) were assessed by SPECT/CMR using 16-segment model. Sensitivity and specificity of CT-MBF (mL/g/min) for detecting the ischemic/infarction and severe infarction were assessed.
  
  
  RESULTS
  The abnormal perfused myocardium and severe infarction were seen in SPECT (n = 90 and n = 19 of 400 segments) and CMR (n = 223 and n = 36 of 448 segments). For detecting the abnormal perfused myocardium, sensitivity and specificity were 80 % (95 %CI, 71-90) and 86 % (95 %CI, 76-91) in SPECT (cut-off MBF, 1.23), and 82 % (95 %CI, 76-88) and 87 % (95 %CI, 80-92) in CMR (cut-off MBF, 1.25). For detecting severe infarction, sensitivity and specificity were 95 % (95 %CI, 52-100) and 72 % (95 %CI, 53-91) in SPECT (cut-off MBF, 0.92), and 78 % (95 %CI, 67-97) and 80 % (95 %CI, 58-86) in CMR (cut-off MBF, 0.98), respectively.
  
  
  CONCLUSIONS
  Dynamic CTP has a potential to detect abnormal perfused myocardium and severe infarction assessed by SPECT/CMR using comparable cut-off MBF.
  
  
  CONCLUSIONS
  • CT-MBF accurately reflects the severity of myocardial perfusion abnormality. • CT-MBF provides good diagnostic accuracy for detecting myocardial perfusion abnormalities. • CT-MBF may assist in stratifying severe myocardial infarction in abnormal perfusion myocardium.
authors: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan. yuki.tanabe.0225@gmail.com.
authors: Yuki
authors: Y
authors: Tanabe
authors: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors: Teruhito
authors: T
authors: Kido
authors: Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors: Teruyoshi
authors: T
authors: Uetani
authors: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors: Akira
authors: A
authors: Kurata
authors: Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors: Tamami
authors: T
authors: Kono
authors: Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors: Akiyoshi
authors: A
authors: Ogimoto
authors: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors: Masao
authors: M
authors: Miyagawa
authors: QMS Group, Quality Assurance Department, FUJIFILM RI Pharma Co., Ltd., Tokyo, Japan.|Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors: Tsutomu
authors: T
authors: Soma
authors: Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Kenya
authors: K
authors: Murase
authors: Center for Clinical Research Data and Biostatistics, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors: Hirotaka
authors: H
authors: Iwaki
authors: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors: Teruhito
authors: T
authors: Mochizuki
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
keywords: Computed tomography; Myocardial blood flow; Myocardial infarction; Myocardial ischemia; Myocardial perfusion imaging