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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

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Stress myocardial perfusion with qualitative magnetic resonance and quantitative dynamic computed tomography:

Martina C de Knegt1,2,3, Alexia Rossi1,2, Steffen E Petersen1,2

  • 1Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, Barts NIHR Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.

European Heart Journal. Cardiovascular Imaging
|October 8, 2020
PubMed

Insights

Cardiovascular magnetic resonance (CMR) perfusion and quantitative CT perfusion imaging are effective for diagnosing significant coronary artery disease (CAD). These methods offer incremental diagnostic value when combined with cardiac computed tomography angiography (CCTA).

Area of Science:

  • Cardiovascular imaging
  • Diagnostic accuracy
  • Coronary artery disease

Background:

  • Non-invasive imaging like cardiovascular magnetic resonance (CMR) perfusion and computed tomography (CT) perfusion can aid in assessing coronary artery disease (CAD).
  • These techniques may help select patients for invasive coronary angiography (ICA).

Purpose of the Study:

  • To evaluate the diagnostic performance of qualitative CMR perfusion and quantitative CT perfusion.
  • To assess their incremental value when used alongside cardiac computed tomography angiography (CCTA).
  • To diagnose haemodynamically significant CAD using fractional flow reserve (FFR) and quantitative coronary angiography (QCA) as references.

Main Methods:

  • Patients with stable angina pectoris underwent CCTA, qualitative CMR perfusion, visual CT perfusion, and quantitative relative myocardial blood flow (CT-MBF) assessment.
  • FFR was measured in vessels with 30-90% stenosis on ICA.
  • Haemodynamically significant CAD was defined by FFR <0.80 or QCA ≥80%.

Main Results:

  • Visual CMR perfusion (AUC 0.84) and relative CT-MBF (AUC 0.86) showed comparable diagnostic performance, outperforming visual CT perfusion (AUC 0.64).
  • Combining CCTA with visual CMR perfusion (AUC 0.91) or relative CT-MBF (AUC 0.92) significantly improved CAD discrimination compared to CCTA alone (P < 0.05).

Conclusions:

  • Qualitative CMR perfusion and relative CT-MBF are superior to visual CT perfusion for diagnosing haemodynamically significant CAD.
  • These imaging modalities provide added diagnostic discrimination when used in conjunction with CCTA.
Abstract

Keywords:
cardiovascular magnetic resonancecomputed tomographydynamic perfusionmyocardial blood flowmyocardial perfusion

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