Eur Radiol (2012) 22:39–50 DOI 10.1007/s00330-011-2260-x
CARDIAC
Non-invasive assessment of functionally relevant coronary artery stenoses with quantitative CT perfusion: preliminary clinical experiences Aaron So & Gerald Wisenberg & Ali Islam & Justin Amann & Walter Romano & James Brown & Dennis Humen & George Jablonsky & Jian-Ying Li & Jiang Hsieh & Ting-Yim Lee
Received: 4 April 2011 / Revised: 23 August 2011 / Accepted: 25 August 2011 / Published online: 21 September 2011 # European Society of Radiology 2011
Abstract Objectives We developed a quantitative Dynamic ContrastEnhanced CT (DCE-CT) technique for measuring Myocardial Perfusion Reserve (MPR) and Volume Reserve (MVR) and studied their relationship with coronary stenosis. Methods Twenty-six patients with Coronary Artery Disease (CAD) were recruited. Degree of stenosis in each coronary artery was classified from catheter-based angiograms as A. So : G. Wisenberg : T.-Y. Lee Imaging Program, Lawson Health Research Institute, London, Ontario, Canada A. So (*) : T.-Y. Lee Imaging Research Laboratories, Robarts Research Institute, 100 Perth Drive, London, Ontario, N6A 5K8, Canada e-mail:
[email protected] A. So : G. Wisenberg : T.-Y. Lee Medical Biophysics, University of Western Ontario, London, Ontario, Canada G. Wisenberg : A. Islam : J. Amann : W. Romano : T.-Y. Lee Medical Imaging, University of Western Ontario, London, Ontario, Canada G. Wisenberg : J. Brown : D. Humen : G. Jablonsky Cardiology, London Health Sciences Centre, London, Ontario, Canada A. Islam : J. Amann : W. Romano Radiology, St. Joseph’s Health Care, London, Ontario, Canada J.-Y. Li : J. Hsieh CT Engineering, GE Healthcare, Waukesha, Wisconsin, USA
Non-Stenosed (NS, angiographically normal or mildly irregular), Moderately Stenosed (MS, 50–80% reduction in luminal diameter), Severely Stenosed (SS, >80%) and SS with Collaterals (SSC). DCE-CT at rest and after dipyridamole infusion was performed using 64-slice CT. Middiastolic heart images were corrected for beam hardening and analyzed using proprietary software to calculate Myocardial Blood Flow (MBF, in mL min-1 100 g-1) and Blood Volume (MBV, in mL 100 g-1) parametric maps. MPR and MVR in each coronary territory were calculated by dividing MBF and MBV after pharmacological stress by their respective baseline values. Results MPR and MVR in MS and SS territories were significantly lower than those of NS territories (p
