Document Detail


Accuracy of dynamic computed tomography adenosine stress myocardial perfusion imaging in estimating myocardial blood flow at various degrees of coronary artery stenosis using a porcine animal model.
MedLine Citation:
PMID:  22178894     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To determine the accuracy of computed tomography (CT) dynamic stress myocardial perfusion imaging to estimate myocardial blood flow (MBF) in a porcine animal model with variable degrees of induced coronary artery stenosis in comparison with microsphere-derived MBF.
METHODS AND MATERIALS: : Seven domestic pigs (36 ± 4 kg) received stents (confirmed 3.0 mm diameter) in the left anterior descending coronary artery distal to first diagonal branch. A balloon catheter was placed within the stent and inflated to various degrees to obtain a defined luminal narrowing (50% and 75% diameter stenosis) as confirmed by intra-arterial flow wire measurement. All models underwent adenosine-mediated (140 μg/kg/min) dynamic stress and rest myocardial perfusion CT imaging using a dual-source CT scanner (shuttle-mode with 100 kV/300 mAs, 20 mL iopromide) with prospective acquisitions every second heartbeat for 30 seconds. CT-estimated MBF (MBFCT) was calculated using a model-based parametric deconvolution method and correlated to that of fluorescent microspheres (MBFmic) injected at each perfusion state.
RESULTS: : All study procedures were performed without complications, and all animals completed the study protocol. Among 448 myocardial segments, 31 (7%) were considered nonevaluable because of motion artifacts. With stress, MBFCT increased significantly (1.10 ± 0.25 vs. 0.80 ± 0.28 mL/g/min, P < 0.001; at stress and rest, respectively) in all myocardial segments and correlated with MBFmic (r = 0.67, P < 0.001). MBFCT overestimated MBFmic, independently of adenosine-stress and degree of coronary stenosis (β = 2.3, 95% confidence interval: 1.81-2.79 mL/g/min, P < 0.001). Although there were no differences in MBFCT between 50% and 75% coronary stenosis at rest (0.01 ± 0.08 mL/g/min, P = 0.86), MBFCT was significantly lower at 75% than at 50% under stress conditions (0.53 ± 0.19 vs. 0.71 ± 0.24 mL/g/min, P = 0.002).
CONCLUSIONS: : CT-derived MBF measurements at rest and stress with varying degrees of coronary stenosis show a valid difference but an underestimated correlation with microsphere-derived MBF in a porcine animal model.
Authors:
Fabian Bamberg; Rabea Hinkel; Florian Schwarz; Torleif A Sandner; Elisabeth Baloch; Roy Marcus; Alexander Becker; Christian Kupatt; Bernd J Wintersperger; Thorsten R Johnson; Daniel Theisen; Ernst Klotz; Maximilian F Reiser; Konstantin Nikolaou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Investigative radiology     Volume:  47     ISSN:  1536-0210     ISO Abbreviation:  Invest Radiol     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0045377     Medline TA:  Invest Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  71-7     Citation Subset:  IM    
Affiliation:
From the Departments of *Clinical Radiology, Ludwig-Maximilians University, Munich, Germany; †Munich Heart Alliance, Munich, Germany; ‡Cardiology, Ludwig-Maximilians University, Munich, Germany; §Department of Medical Imaging, University of Toronto, Ontario, Canada; and ‖Siemens Healthcare, Forchheim, Germany.
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