Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

Autor: Atsushi K. Kono, Admir Dedic, Marisa Lubbers, Koen Nieman, Marcel L. Dijkshoorn, Adriano Rossi, Robert-Jan van Geuns, Akira Kurata, Adriaan Coenen, Raluca G. Chelu
Přispěvatelé: Cardiology, Radiology & Nuclear Medicine
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Perfusion scanning
X-ray computed
Fractional flow reserve
Coronary Artery Disease
030204 cardiovascular system & hematology
Fractional flow reserve
myocardial
Coronary Angiography
Severity of Illness Index
030218 nuclear medicine & medical imaging
Coronary artery disease
03 medical and health sciences
Myocardial perfusion imaging
0302 clinical medicine
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Prospective Studies
Tomography
Neuroradiology
Aged
Receiver operating characteristic
medicine.diagnostic_test
business.industry
Coronary Stenosis
Hemodynamics
Myocardial Perfusion Imaging
General Medicine
Blood flow
Middle Aged
medicine.disease
Perfusion
Radiology Nuclear Medicine and imaging
Cardiology
Female
Radiology
business
Tomography
X-Ray Computed
Cardiac
circulatory and respiratory physiology
Zdroj: European Radiology, 27(6), 2309-2316. Springer-Verlag
European Radiology
ISSN: 1432-1084
0938-7994
Popis: To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model. An absolute MBF value was measured in the suspected perfusion defect. TPR was defined as the ratio between the subendocardial and subepicardial MBF. TPR and MBF results were compared with invasive FFR using a threshold of 0.80. Forty-three patients and 94 territories were analysed. The area under the receiver operator curve was larger for MBF (0.78) compared with TPR (0.65, P = 0.026). No significant differences were found in diagnostic classification between MBF and TPR with a territory-based accuracy of 77 % (67-86 %) for MBF compared with 70 % (60-81 %) for TPR. Combined MBF and TPR classification did not improve the diagnostic classification. Dynamic CT-MPI-based transmural perfusion ratio predicts haemodynamically significant coronary artery disease. However, diagnostic performance of dynamic CT-MPI-derived TPR is inferior to quantified MBF and has limited incremental value. • The transmural perfusion ratio from dynamic CT-MPI predicts functional obstructive coronary artery disease • Performance of the transmural perfusion ratio is inferior to quantified myocardial blood flow • The incremental value of the transmural perfusion ratio is limited
Databáze: OpenAIRE
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