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European Radiology
Published in: European Radiology 11/2016

01-11-2016 | Cardiac

Differentiation of myocardial ischemia and infarction assessed by dynamic computed tomography perfusion imaging and comparison with cardiac magnetic resonance and single-photon emission computed tomography

Authors: Yuki Tanabe, Teruhito Kido, Teruyoshi Uetani, Akira Kurata, Tamami Kono, Akiyoshi Ogimoto, Masao Miyagawa, Tsutomu Soma, Kenya Murase, Hirotaka Iwaki, Teruhito Mochizuki

Published in: European Radiology | Issue 11/2016

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Abstract

Objectives

To evaluate the feasibility of myocardial blood flow (MBF) by computed tomography from dynamic CT perfusion (CTP) for detecting myocardial ischemia and infarction assessed by cardiac magnetic resonance (CMR) or single-photon emission computed tomography (SPECT).

Methods

Fifty-three patients who underwent stress dynamic CTP and either SPECT (n = 25) or CMR (n = 28) were retrospectively selected. Normal and abnormal perfused myocardium (ischemia/infarction) were assessed by SPECT/CMR using 16-segment model. Sensitivity and specificity of CT-MBF (mL/g/min) for detecting the ischemic/infarction and severe infarction were assessed.

Results

The abnormal perfused myocardium and severe infarction were seen in SPECT (n = 90 and n = 19 of 400 segments) and CMR (n = 223 and n = 36 of 448 segments). For detecting the abnormal perfused myocardium, sensitivity and specificity were 80 % (95 %CI, 71-90) and 86 % (95 %CI, 76-91) in SPECT (cut-off MBF, 1.23), and 82 % (95 %CI, 76-88) and 87 % (95 %CI, 80-92) in CMR (cut-off MBF, 1.25). For detecting severe infarction, sensitivity and specificity were 95 % (95 %CI, 52-100) and 72 % (95 %CI, 53-91) in SPECT (cut-off MBF, 0.92), and 78 % (95 %CI, 67-97) and 80 % (95 %CI, 58-86) in CMR (cut-off MBF, 0.98), respectively.

Conclusions

Dynamic CTP has a potential to detect abnormal perfused myocardium and severe infarction assessed by SPECT/CMR using comparable cut-off MBF.

Key Points

• CT-MBF accurately reflects the severity of myocardial perfusion abnormality.
• CT-MBF provides good diagnostic accuracy for detecting myocardial perfusion abnormalities.
• CT-MBF may assist in stratifying severe myocardial infarction in abnormal perfusion myocardium.
Appendix
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Metadata
Title
Differentiation of myocardial ischemia and infarction assessed by dynamic computed tomography perfusion imaging and comparison with cardiac magnetic resonance and single-photon emission computed tomography
Authors
Yuki Tanabe
Teruhito Kido
Teruyoshi Uetani
Akira Kurata
Tamami Kono
Akiyoshi Ogimoto
Masao Miyagawa
Tsutomu Soma
Kenya Murase
Hirotaka Iwaki
Teruhito Mochizuki
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4238-1

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