Adenosine-stress dynamic real-time myocardial perfusion CT and adenosine-stress first-pass dual-energy myocardial perfusion CT for the assessment of acute chest pain: Initial results
| Autor: | U. Joseph Schoepf, Ashok Ramachandra, Philip Costello, Garrett W. Rowe, Thomas Henzler, Markus Weininger, Christian Fink |
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| Rok vydání: | 2012 |
| Předmět: |
Chest Pain
medicine.medical_specialty Adenosine Vasodilator Agents Radiography Population Pilot Projects Perfusion scanning Coronary Angiography Chest pain Sensitivity and Specificity Radiography Dual-Energy Scanned Projection Myocardial perfusion imaging Text mining Computer Systems medicine Humans Radiology Nuclear Medicine and imaging education Aged education.field_of_study medicine.diagnostic_test business.industry Myocardial Perfusion Imaging Reproducibility of Results General Medicine Middle Aged Acute Disease Exercise Test Tomography Radiology medicine.symptom Tomography X-Ray Computed business Nuclear medicine Perfusion |
| Zdroj: | European Journal of Radiology. 81:3703-3710 |
| ISSN: | 0720-048X |
| DOI: | 10.1016/j.ejrad.2010.11.022 |
| Popis: | Purpose Recent innovations in CT enable the evolution from mere morphologic imaging to dynamic and functional testing. We describe our initial experience performing myocardial stress perfusion CT in a clinical population with acute chest pain. Methods and materials Myocardial stress perfusion CT was performed on twenty consecutive patients (15 men, 5 women; mean age 65 ± 8 years) who presented with acute chest pain and were clinically referred for stress/rest SPECT and cardiac MRI. Prior to CT each patient was randomly assigned either to Group A or to Group B in a consecutive order (10 patients per group). Group A underwent adenosine-stress dynamic real-time myocardial perfusion CT using a novel “shuttle” mode on a 2nd generation dual-source CT. Group B underwent adenosine-stress first-pass dual-energy myocardial perfusion CT using the same CT scanner in dual-energy mode. Two experienced observers visually analyzed all CT perfusion studies. CT findings were compared with MRI and SPECT. Results In Group A 149/170 myocardial segments (88%) could be evaluated. Real-time perfusion CT (versus SPECT) had 86% (84%) sensitivity, 98% (92%) specificity, 94% (88%) positive predictive value, and 96% (92%) negative predictive value in comparison with perfusion MRI for the detection of myocardial perfusion defects. In Group B all myocardial segments were available for analysis. Compared with MRI, dual-energy myocardial perfusion CT (versus SPECT) had 93% (94%) sensitivity, 99% (98%) specificity, 92% (88%) positive predictive value, and 96% (94%) negative predictive value for detecting hypoperfused myocardial segments. Conclusion Our results suggest the clinical feasibility of myocardial perfusion CT imaging in patients with acute chest pain. Compared to MRI and SPECT both, dynamic real-time perfusion CT and first-pass dual-energy perfusion CT showed good agreement for the detection of myocardial perfusion defects. |
| Databáze: | OpenAIRE |
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