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[Perfusion studies of the myocardium using computerized tomography. Comparative studies in normal persons and
Insights
This study introduces a new computed tomography (CT) method for assessing myocardial perfusion. The technique effectively identifies perfusion differences in patients with coronary artery disease.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Conventional computed tomography (CT) is vital for assessing cardiac anatomy but not routinely used for myocardial perfusion.
- Investigating myocardial perfusion noninvasively is crucial for diagnosing and managing heart conditions.
Purpose of the Study:
- To describe and evaluate a novel CT-based method for delineating myocardial perfusion differences.
- To assess the feasibility of this new CT technique in patients with coronary artery disease.
Main Methods:
- Utilized a Siemens Somatom SF scanner with a 5-second scan time.
- Performed CT imaging before and after intravenous contrast medium injection, with and without dipyridamole.
- Quantitatively analyzed CT images via circumferential density measurements in myocardial segments.
Main Results:
- Developed a novel CT method enabling visualization of myocardial perfusion variations.
- Successfully applied the technique to healthy subjects and patients with coronary artery disease.
- Defined two indexes to quantify perfusion disturbances based on density profiles.
Conclusions:
- The described CT method offers a promising approach for noninvasive myocardial perfusion assessment.
- This technique can differentiate perfusion abnormalities in patients with coronary artery disease.
- Further research may establish CT as a routine tool for evaluating myocardial perfusion.
Abstract:
As a noninvasive method of examination, conventional computer tomography (CT) has assumed an important role in assessment of pathologic anatomy of the heart. In contrast, previously, CT has not been applied for routine investigations of myocardial perfusion. In this study, a new method is described which, with intravenous injection of contrast medium, enables delineation of perfusion differences in the myocardium. Studies were performed in ten healthy male subjects and 71 patients with angiographically-documented coronary artery disease with a Somatom SF (Siemens) with a scanning time of five seconds. Prior to contrast injection, a native scan was obtained in the short axis view of the left ventricle as well as in apical and central view. After injection of 30 ml of contrast medium through a 7F ring catheter positioned in the inferior vena cava, imaging was again performed and then repeated subsequent to administration of 0.5 mg/kg dipyridamole. Quantitative evaluation of the CT images was carried out through circumferential analysis of the apical and central segments. The circumference was divided into 60 segments of six degrees each and for each segment ten density measurements were performed to obtain average values subendocardially, intramurally and subepicardially. After correction for the density value of the ascending aorta in healthy subjects, the density profile was constructed. The density profile of the healthy subjects was designated as the mean value curve. The circumferential profile of patients with coronary artery disease was tested against the mean value curve from which two indexes for description of perfusion disturbances were defined.(ABSTRACT TRUNCATED AT 250 WORDS)