Quantitative myocardial perfusion analysis using multi-row detector CT in acute myocardial infarction

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Acute myocardial infarction (AMI) requires accurate assessment of myocardial perfusion.
• Quantitative myocardial perfusion imaging (MPI) aims to provide objective measures of blood flow.
• Multi-row detector CT (MDCT) offers potential for high-resolution anatomical and functional imaging.

Purpose of the Study:

• To evaluate the feasibility of quantitative MPI in patients with AMI using MDCT.
• To assess perfusion parameters like tissue blood flow (TBF), tissue blood volume (TBV), and mean transit time (MTT).
• To compare MDCT-derived perfusion data with clinical parameters, angiography, SPECT, and cardiac MRI.

Main Methods:

• Fifteen healthy subjects and 26 AMI patients underwent MDCT-based MPI.
• A model-based deconvolution method was employed to derive perfusion parameters.
• Comparison with clinical data, coronary angiography, SPECT, and cardiac MRI was performed.

Main Results:

• Infarcted myocardium showed significantly lower TBF and TBV compared to non-infarcted areas (p<0.01).
• MTT did not significantly differ between infarcted and non-infarcted regions.
• CT-MPI TBF measurements correlated well with MRI-derived TBF (R=0.55, p<0.01).

Conclusions:

• MDCT perfusion imaging with deconvolution analysis enables quantitative detection of perfusion abnormalities in AMI.
• This technique provides a foundation for non-invasive, quantitative assessment of myocardial infarction.
• MDCT-MPI shows promise for evaluating myocardial viability and infarct size.