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Large variation in blood flow between left ventricular segments, as detected by adenosine stress dynamic CT perfusion.
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- De Geer, Jakob (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för radiologiska vetenskaper,Hälsouniversitetet,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Röntgenkliniken i Linköping
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- Gjerde, Marcus (author)
- Östergötlands Läns Landsting,Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Kardiologiska kliniken US,Centrum för medicinsk bildvetenskap och visualisering, CMIV
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- Brudin, Lars (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Hälsouniversitetet,Department of Clinical Physiology in Kalmar, Linköping University, County Council of Kalmar, Kalmar, Sweden
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- (creator_code:org_t)
- 2014-05-19
- 2015
- English.
- In: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961 .- 1475-097X. ; 35:4, s. 291-300
- Journal article (peer-reviewed)
Abstract
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- BACKGROUND: Dynamic cardiac CT perfusion (CTP) is based on repeated imaging during the first-pass contrast agent inflow. It is a relatively new method that still needs validation.PURPOSE: To evaluate the variation in adenosine stress dynamic CTP blood flow as compared to (99m) Tc SPECT. Secondarily, to compare manual and automatic segmentation.METHODS: Seventeen patients with manifest coronary artery disease were included. Nine were excluded from evaluation for various reasons. All patients were examined with dynamic stress CTP and stress/rest SPECT. CTP blood flow was compared with SPECT on a per segment basis. Results for manual and automated AHA segmentation were compared.RESULTS: CTP showed a positive correlation with SPECT, with correlation coefficients of 0·38 and 0·41 for manual and automatic segmentation, respectively (P<0·0001). There was no significant difference between the correlation coefficients of the manual and automated segmentation procedures (P = 0·75). The average per individual global CTP blood flow value for normal segments varied by a factor of 1·9 (manual and automatic segmentation). For the whole patient group, the CTP blood flow value in normal segments varied by a factor of 2·9/2·7 (manual/automatic segmentation). Within each patient, the average per segment blood flow in normal segments varied by a factor of 1·3-2·0/1·2-2·1 (manual/automatic segmentation).CONCLUSION: A positive but rather weak correlation was found between CTP and (99m) Tc SPECT. Large variations in CTP blood flow suggest that a cut-off value for stress myocardial blood flow is inadequate to detect ischaemic segments. Dynamic CTP is hampered by a limited coverage.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
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- De Geer, Jakob
- Gjerde, Marcus
- Brudin, Lars
- Olsson, Eva
- Persson, Anders
- Engvall, Jan
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