Assessment of myocardial perfusion and viability from routine contrast-enhanced 16-detector-row computed tomography of the heart: preliminary results

Nikolaou, Konstantin; Sanz, Javier; Poon, Michael; Wintersperger, Bernd J.; Ohnesorge, Bernd; Rius, Teresa; Fayad, Zahi A.; Reiser, Maximilian; Becker, Christoph R.

doi:10.1007/s00330-005-2672-6

Cited by 131 publications

(74 citation statements)

References 24 publications

(26 reference statements)

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“…Overall, there was a good agreement between corDSCTA and SPECT at both rest (k50.64) and stress (k50.74). A number of recent studies have addressed the topic of CT myocardial perfusion in both animals [16] and humans [30,31]. Animal studies have demonstrated that MDCT can be utilised to evaluate myocardial perfusion differences at rest and stress [16].…”

Section: Discussionmentioning

confidence: 99%

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Cheng

Zeng²,

Arellano³

et al. 2010

BJR

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ABSTRACT. We compared coronary dual-source computed tomography angiography (corDSCTA) with technetium-99m single-photon emission computed tomography (SPECT) for the detection of myocardial perfusion abnormalities. Fifty-five consecutive patients underwent both gated myocardial perfusion SPECT and corDSCTA, the latter during a single arterial-phase injection of contrast agent. The perfusion defects visualised by corDSCTA correlated with the findings of rest/stress SPECT. Abnormal findings on stress SPECT, which were due to either ischaemia or infarct, were found in 24 patients. In comparison to SPECT at rest, corDSCTA detected perfusion defects with a sensitivity and specificity of 100% and 78%, respectively. Compared to SPECT at stress, the sensitivity and specificity values of corDSCTA were 83.3% and 90.3%, respectively. On corDSCTA , the average attenuation values of perfusion defects that corresponded to chronic infarcts (28.5¡22.2 HU) were significantly lower (p50.002) than those of non-infarct-related perfusion defects (43.1¡17.5 HU). Using rest/stress SPECT is the gold standard for the diagnosis of myocardial ischaemia, corDSCTA was able to diagnose ischaemic disease (defined as the presence of high-grade stenotic CAD (>50% luminal narrowing)) with a sensitivity and specificity of 59% and 89%, respectively, in patients with no known history of myocardial infarction (n54). Thus, corDSCTA may serve as a diagnostic tool for the detection of perfusion abnormalities (first) visualised by SPECT. There appears to be a limited correlation between coronary stenotic disease and SPECT findings. Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality in developed countries. During the progression of atherosclerosis, the coronary artery wall undergoes pathological changes with build-up of plaque and subsequent luminal narrowing resulting in impaired blood supply to the myocardium. The focus of perfusion imaging is the detection of pathological changes in myocardial perfusion. At present, various perfusion imaging techniques are in clinical use, including nuclear medicine modalities such as single-photon emission computed tomography (SPECT), positron emission tomography (PET) and cardiac perfusion MRI.Rest/stress myocardial perfusion SPECT imaging is a non-invasive modality that is widely used to evaluate patients with suspected CAD. Compared with conventional coronary angiography, myocardial perfusion SPECT has demonstrated sensitivities and specificities of 82-98% and 44-91%, respectively, for the detection of CAD [1,2]. SPECT findings such as the extent, severity and reversibility of perfusion defects have shown to be valuable for the prediction of future cardiovascular events [3]. In the absence of morphological correlation, however, SPECT is limited in allocating perfusion defects to their determining coronary lesion, which is a major precondition for accurate therapy planning [4]. As a consequence, invasive conventional coronary angiography (CCA) is often performed in cases of abnorma...

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Section: Discussionmentioning

confidence: 99%

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Cheng

Zeng²,

Arellano³

et al. 2010

BJR

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“…Perfusion and viability may be assessed with CCT (66)(67)(68)(69). In the past decades, areas of suspected MI were mainly investigated by nuclear medicine techniques.…”

Section: Diagnostic Performancementioning

confidence: 99%

Infarct characterization using CT

Grutta

Toia

Maffei

et al. 2017

Cardiovasc. Diagn. Ther.

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Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination.Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.

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“…Differentiation between ischemia and MI is not possible by using first pass CTA acquisition alone [60]. Shapiro et al [61] investigated the prognostic value of the extent of hypodense areas in patients with MI.…”

Section: Cardiac Ct For Myocardial Viability-technical Pointsmentioning

confidence: 99%

Novel MRI and CT Approaches for the Characterization of Myocardial Infarct

et al. 2013

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Accurate myocardial viability assessment is essential to optimize revascularization and/or medical treatment in patients with myocardial infarct. To date, cardiac magnetic resonance imaging (MRI) is the widely accepted clinical standard for visualization, characterization and quantification of myocardial viability. Multidetector computed tomography (CT) is reported by numerous authors as an emerging imaging modality for myocardial viability assessment. This review article summarizes cardiac MRI and CT modalities for myocardial viability assessment.

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Assessment of myocardial perfusion and viability from routine contrast-enhanced 16-detector-row computed tomography of the heart: preliminary results

Cited by 131 publications

References 24 publications

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Detection of myocardial perfusion abnormalities: standard dual-source coronary computed tomography angiography versus rest/stress technetium-99m single-photo emission CT

Infarct characterization using CT

Novel MRI and CT Approaches for the Characterization of Myocardial Infarct

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