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European Radiology
Published in: European Radiology 10/2018

01-10-2018 | Cardiac

Comprehensive morphologic and functional imaging of heart transplant patients: first experience with dynamic perfusion CT

Authors: S. Oebel, S. Hamada, K. Higashigaito, J. von Spiczak, E. Klotz, F. Enseleit, R. Hinzpeter, F. Ruschitzka, R. Manka, H. Alkadhi

Published in: European Radiology | Issue 10/2018

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Abstract

Objectives

We aimed to assess the diagnostic performance of a combined protocol with coronary computed tomography angiography (CCTA) and stress CT perfusion imaging (CTP) in heart transplant patients for comprehensive morphological and functional imaging.

Methods

In this prospective study, 13 patients undergoing routine follow-up 8±6 years after heart transplantation underwent CCTA and dynamic adenosine stress CTP using a third-generation dual-source CT scanner, cardiac magnetic resonance (MR) adenosine stress perfusion imaging at 1.5 T, and catheter coronary angiography. In CCTA stenoses >50% luminal diameter narrowing were noted. Myocardial perfusion deficits were documented in CTP and MR. Quantitative myocardial blood flow (MBF) was calculated with CTP. Left ventricular ejection fraction was determined on cardiac MR cine images. Radiation doses of CT were determined.

Results

One of the 13 patients had to be excluded because of severe motion artifacts. CCTA identified three patients with stenosis >50%, which were confirmed with catheter coronary angiography. CTP showed four patients with stress-induced myocardial hypoperfusion, which were confirmed by MR stress perfusion imaging. Quantitative analysis of global MBF showed lower mean values as compared to known reference values (MBF under stress 125.5 ± 34.5 ml/100 ml/min). Average left ventricular ejection fraction was preserved (56 ± 5%).

Conclusions

In heart transplant patients, a comprehensive CT protocol for the assessment of morphology and function including CCTA and CTP showed good concordance to results from MR perfusion imaging and catheter coronary angiography.

Key Points

• Stress CT perfusion imaging enables the detection of myocardial ischemia
• CT myocardial perfusion imaging can be combined with coronary computed tomography angiography
• Combining perfusion and coronary CT imaging is accurate in heart transplant patients
• CT myocardial perfusion imaging can be performed at a reasonable radiation dose
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Metadata
Title
Comprehensive morphologic and functional imaging of heart transplant patients: first experience with dynamic perfusion CT
Authors
S. Oebel
S. Hamada
K. Higashigaito
J. von Spiczak
E. Klotz
F. Enseleit
R. Hinzpeter
F. Ruschitzka
R. Manka
H. Alkadhi
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5436-9

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