Normal values of myocardial blood flow measured with dynamic myocardial computed tomography perfusion

Area of Science:

• Cardiovascular Imaging
• Radiology
• Functional Cardiac Assessment

Background:

• Dynamic myocardial computed tomography (CT) perfusion (DM-CTP) combined with coronary CT angiography (CCTA) offers anatomical and functional insights into coronary artery disease (CAD).
• Establishing normal reference values for myocardial blood flow (MBF) is crucial for accurately identifying impaired perfusion in patients with suspected CAD.

Purpose of the Study:

• To determine normal values for MBF using DM-CTP in a healthy cohort.
• To investigate the influence of age and sex on MBF.
• To analyze the regional distribution of MBF within the myocardium.

Main Methods:

• 82 healthy individuals (46 women, aged 45-78) with normal CCTA underwent rest and adenosine stress DM-CTP.
• Global and segmental MBF were quantified.
• Statistical analyses assessed differences related to sex, age, and myocardial segments.

Main Results:

• Global MBF at rest was 0.93 ± 0.42 mL/min/g and during stress was 3.58 ± 1.14 mL/min/g.
• No significant differences in MBF were found between sexes or in correlation with age.
• Significant intersegmental heterogeneity in MBF was observed across the 16 myocardial segments.

Conclusions:

• Normal MBF values assessed by DM-CTP exhibit significant intersegmental variation in healthy individuals.
• Age, sex, and coronary dominance do not appear to influence these MBF values.
• Established normal MBF values are valuable for clinical assessment of myocardial ischemia using DM-CTP.