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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Myocardial perfusion defect in patients with coronary artery disease demonstrated by 64-multidetector computed

Kohichiro Iwasaki1, Takeshi Matsumoto

  • 1Department of Cardiology, Okayama Kyokuto Hospital, 567-1 Kurata, Nakaku, Okayama, Japan. kiwasaki@kyokuto.or.jp

Clinical Cardiology
|June 11, 2011
PubMed

Insights

Myocardial perfusion defects (MPD) detected by 64-multidetector computed tomography (MDCT) at rest indicate ischemia in coronary artery disease patients. Revascularization therapy effectively resolves these defects, suggesting MPD

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Diagnostic Cardiology

Background:

  • Pharmacological stress 64-multidetector computed tomography (MDCT) assesses myocardial perfusion.
  • Detection of myocardial ischemia at rest using MDCT remains under-investigated.
  • This study investigates myocardial perfusion defects (MPD) at rest using 64-MDCT and the impact of revascularization therapy.

Purpose of the Study:

  • To determine the incidence of myocardial perfusion defects (MPD) using 64-MDCT at rest in patients with coronary artery disease.
  • To assess the effect of coronary revascularization therapy on MPD.
  • To establish if MPD detected at rest by 64-MDCT signifies myocardial ischemia.

Main Methods:

  • 76 coronary artery disease patients undergoing 64-MDCT before and after revascularization, plus 55 controls, were studied.
  • Patients were grouped by coronary artery stenosis severity (70-90%, 50-69%, 30-49%, 10-29%).
  • Myocardial perfusion defect (MPD) was defined as hypoenhancement (<50 HU) during diastole on 64-MDCT.

Main Results:

  • MPD incidence was 60.0% in 70-90% stenosis (Group A) and 32.4% in 50-69% stenosis (Group B).
  • MPD was significantly less frequent in lower stenosis groups (4.8% in Group C, 0% in Group D).
  • Revascularization therapy resolved MPD in most patients; no new defects appeared post-therapy.

Conclusions:

  • Significant coronary artery stenosis is associated with a high incidence of myocardial perfusion defects (MPD) detectable by 64-MDCT at rest.
  • These MPDs likely represent myocardial ischemia.
  • Revascularization therapy is effective in resolving MPD, supporting its diagnostic utility.
Abstract

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