Functional assessment of coronary artery flow using adenosine stress dual-energy CT: a preliminary study

We attempted to assess coronary artery flow using adenosine-stress and dual-energy mode with dual-source CT (DE-CT). Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who...

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Veröffentlicht in:The International Journal of Cardiovascular Imaging 2011-03, Vol.27 (3), p.471-481
Hauptverfasser: Nagao, Michinobu, Kido, Teruhito, Watanabe, Kouki, Saeki, Hideyuki, Okayama, Hideki, Kurata, Akira, Hosokawa, Kohei, Higashino, Hiroshi, Mochizuki, Teruhito
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container_title The International Journal of Cardiovascular Imaging
container_volume 27
creator Nagao, Michinobu
Kido, Teruhito
Watanabe, Kouki
Saeki, Hideyuki
Okayama, Hideki
Kurata, Akira
Hosokawa, Kohei
Higashino, Hiroshi
Mochizuki, Teruhito
description We attempted to assess coronary artery flow using adenosine-stress and dual-energy mode with dual-source CT (DE-CT). Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who performed adenosine stress CT, and 8 patients who performed rest CT as controls. We reconstructed an iodine map and composite images at 120 kV (120 kV images) using raw data with scan parameters of 100 and 140 kV. We measured mean attenuation in the coronary artery proximal to the distal portion on both the iodine map and 120 kV images. Coronary enhancement ratio (CER) was calculated by dividing mean attenuation in the coronary artery by attenuation in the aortic root, and was used as an estimate of coronary enhancement. Coronary stenosis was identified as a reduction in diameter of >50% on CT angiogram, and myocardial ischemia was diagnosed by adenosine-stress myocardial perfusion scintigraphy. The iodine map showed that CER was significantly lower for ischemic territories (0.76 ± 0.06) or stenosed coronary arteries (0.77 ± 0.06) than for non-ischemic territories (0.95 ± 0.21, P  = 0.02) or non-stenosed coronary arteries (1.07 ± 0.33, P  
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Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who performed adenosine stress CT, and 8 patients who performed rest CT as controls. We reconstructed an iodine map and composite images at 120 kV (120 kV images) using raw data with scan parameters of 100 and 140 kV. We measured mean attenuation in the coronary artery proximal to the distal portion on both the iodine map and 120 kV images. Coronary enhancement ratio (CER) was calculated by dividing mean attenuation in the coronary artery by attenuation in the aortic root, and was used as an estimate of coronary enhancement. Coronary stenosis was identified as a reduction in diameter of &gt;50% on CT angiogram, and myocardial ischemia was diagnosed by adenosine-stress myocardial perfusion scintigraphy. 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Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who performed adenosine stress CT, and 8 patients who performed rest CT as controls. We reconstructed an iodine map and composite images at 120 kV (120 kV images) using raw data with scan parameters of 100 and 140 kV. We measured mean attenuation in the coronary artery proximal to the distal portion on both the iodine map and 120 kV images. Coronary enhancement ratio (CER) was calculated by dividing mean attenuation in the coronary artery by attenuation in the aortic root, and was used as an estimate of coronary enhancement. Coronary stenosis was identified as a reduction in diameter of &gt;50% on CT angiogram, and myocardial ischemia was diagnosed by adenosine-stress myocardial perfusion scintigraphy. The iodine map showed that CER was significantly lower for ischemic territories (0.76 ± 0.06) or stenosed coronary arteries (0.77 ± 0.06) than for non-ischemic territories (0.95 ± 0.21, P  = 0.02) or non-stenosed coronary arteries (1.07 ± 0.33, P  &lt; 0.001). The 120 kV images showed no difference in CER between these two groups. Use of CER on the iodine map separated ischemic territories from non-ischemic territories with a sensitivity of 86% and a specificity of 75%. Our quantification is the first non-invasive analytical technique for assessment of coronary artery flow using cardiac CT. 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Data of 18 patients with suspected coronary arteries disease who had undergone cardiac DE-CT were retrospectively analyzed. The patients were divided into two groups: 10 patients who performed adenosine stress CT, and 8 patients who performed rest CT as controls. We reconstructed an iodine map and composite images at 120 kV (120 kV images) using raw data with scan parameters of 100 and 140 kV. We measured mean attenuation in the coronary artery proximal to the distal portion on both the iodine map and 120 kV images. Coronary enhancement ratio (CER) was calculated by dividing mean attenuation in the coronary artery by attenuation in the aortic root, and was used as an estimate of coronary enhancement. Coronary stenosis was identified as a reduction in diameter of &gt;50% on CT angiogram, and myocardial ischemia was diagnosed by adenosine-stress myocardial perfusion scintigraphy. The iodine map showed that CER was significantly lower for ischemic territories (0.76 ± 0.06) or stenosed coronary arteries (0.77 ± 0.06) than for non-ischemic territories (0.95 ± 0.21, P  = 0.02) or non-stenosed coronary arteries (1.07 ± 0.33, P  &lt; 0.001). The 120 kV images showed no difference in CER between these two groups. Use of CER on the iodine map separated ischemic territories from non-ischemic territories with a sensitivity of 86% and a specificity of 75%. Our quantification is the first non-invasive analytical technique for assessment of coronary artery flow using cardiac CT. CER on the iodine map is a candidate method for demonstration of alteration in coronary artery flow under adenosine stress, which is related to the physiological significance of coronary artery disease.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>20686853</pmid><doi>10.1007/s10554-010-9676-2</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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subjects Adenosine
Aged
Aged, 80 and over
Cardiac Imaging
Cardiology
Case-Control Studies
Contrast Media
Coronary Angiography - methods
Coronary Circulation
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - physiopathology
Female
Humans
Imaging
Iopamidol
Japan
Male
Medicine
Medicine & Public Health
Middle Aged
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - physiopathology
Myocardial Perfusion Imaging - methods
Original Paper
Pilot Projects
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Radiology
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Vasodilator Agents
title Functional assessment of coronary artery flow using adenosine stress dual-energy CT: a preliminary study
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