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Updated: Jul 11, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Dynamic CT-perfusion parameters as indicators of microcirculation: investigation in patients without obstructive
M Takafuji1, K Kitagawa1, M Ishida1
1Department of Radiology, Mie University Graduate School of Medicine, Tsu, Japan.
Insights
Coronary CT perfusion (CTP) parameters like myocardial blood flow (MBF) and myocardial blood volume (MBV) correlate with smoking status. Extravascular extracellular volume (EEV) and flow extraction product (FE) relate to age, suggesting distinct microvascular dysfunction mechanisms.
Area of Science:
- Cardiovascular imaging
- Physiology
- Radiology
Background:
- Coronary artery disease (CAD) diagnosis relies on assessing coronary stenosis and microvascular function.
- Coronary CT perfusion (CTP) offers insights into myocardial blood flow (MBF) and volume (MBV).
- Understanding CTP parameter relationships with patient characteristics is crucial for interpreting microvascular function in non-obstructive CAD.
Purpose of the Study:
- To investigate the associations between CTP parameters and patient demographics in individuals without obstructive CAD.
- To determine if CTP parameters like MBF, MBV, perfused capillary blood volume (PCBV), extravascular extracellular volume (EEV), and flow extraction product (FE) correlate differently with patient characteristics.
Main Methods:
- Seventy-seven patients with suspected CAD underwent coronary CT angiography (CCTA) and dynamic CTP.
- Patients with obstructive coronary stenosis (≥50%) were excluded.
- MBF, MBV, PCBV, EEV, and FE were calculated from CTP data using established models.
Main Results:
- MBF, MBV, and PCBV showed strong intercorrelations (r > 0.80, p < 0.001).
- FE and EEV were also strongly correlated (r = 0.88, p < 0.001).
- Smoking status independently predicted MBF, MBV, and PCBV, while age independently predicted FE and EEV (p < 0.05).
Conclusions:
- CTP parameters can be categorized into two groups based on their associations with patient characteristics: MBF/MBV/PCBV and FE/EEV.
- These findings suggest that FE and EEV may represent distinct mechanisms of microvascular dysfunction compared to MBF, MBV, and PCBV.
Aim:
To investigate the relationship between each CTP parameter and that between CTP parameters and patient characteristics in patients without obstructive coronary artery disease (CAD).
Materials And Methods:
Seventy-seven (28 female; 65.0±10.3 years) patients with suspected CAD who underwent coronary CT angiography (CCTA) and dynamic CTP with vasodilator stress were included. Patients with obstructive coronary stenosis (≥50%) on CCTA were excluded. Myocardial blood flow (MBF) and myocardial blood volume (MBV) were calculated using the slope and peak of the time-attenuation curves of the myocardium and blood. Perfused capillary blood volume (PCBV), extravascular extracellular volume (EEV), and flow extraction product (FE) were calculated using the extended Tofts model.
Results:
MBF, MBV, and PCBV were strongly correlated with each other (all r > 0.80 and all p < 0.001), whereas FE and EEV were strongly correlated with each other (r = 0.88 and p < 0.001). In univariate linear regression analysis, male sex and smoking status were significantly associated with MBF, MBV, and PCBV, while age was significantly associated with FE and EEV (all p < 0.05). In stepwise multivariate analysis, smoking status was independently associated with MBF, MBV. and PCBV, while age was the only factor associated with FE and EEV (all p < 0.05).
Conclusion:
FE and EEV may reflect different mechanisms of microvascular dysfunction than MBF, MBV, and PCBV.
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