| Objective To evaluate the reproducibility of the measurement of myocardial blood flow by stress dynamic CT myocardial perfusion imaging(CT-MPI).Methods Patients suspected of having coronary artery disease underwent coronary computed tomographic angiography and ATP stress CT-MPI.A total of 25 cases were enrolled with average age of 55.8±7.1 years,including 17 cases of male(68%).CT-MPI results were quantitatively analyzed by two readers in segmental bases,including myocardial blood flow(MBF),myocardial blood volume(MBV)as well as time to peak(TTP).Reproducibility of inter-reader and intra-reader measurements of myocardial blood flow were evaluated.Results All the cases were examed successfully without side-effects.The radiation dose was 4.9 ± 0.9 m Sv for the CT-MPI scanning.The inter-reader and intra-reader reproducibility were good for the quantification of myocardial perfusion in a segmental basis,deriving Kappa values of0.893 and 0.862,respectively(P < 0.001),and correlation coefficient of 0.949 and0.937,respectively(P<0.001)for MBF measurements.The mean MBF for int-reader(130.18 ± 57.0 versus 130.16 ± 57.7 m L/100 m L/min)and intra-reader(131.7 ±58.5 versus 131.3 ± 58.1 m L/100 m L/min),respectively.The mean difference were0.024 ± 18.4 m L/100 m L/min and 0.400 ± 20.7 m L/100 m L/min(all P values >0.05).The 95% limit of agreements for the inter-and intra-reader were-35.9to 36.0 m L/100 m L/min and-40.2 to 41.0 m L/100 m L/min,respectively.Conclusion Both inter-and intra-reader reproducibility for the measurements of myocardial perfusion on stress dynamic CT-MPI were good.Objective To assess effects of stress dynamic CT myocardial perfusion imaging(CT-MPI)on the diagnosis of myocardial perfusion defects in coronary artery disease(CAD).Methods Patients suspected of having CAD underwent ATP stress CT-MPI.Nuclear myocardial perfusion imaging(NMPI)was performed within one week.CT-MPI results were qualitatively analyzed,and myocardial blood flow(MBF),myocardial blood volume(MBV)as well as time to peak(TTP)were quantified according to CT-MPI.Effects of CT-MPI on predicting myocardial perfusion defects were assessed in comparison with NMPI.Results Twenty five patients were enrolled in our study.MBF [76.3(60.2,88.8)versus 127.4(105.5,159.1)m L/100 m L/min] and MBV(8.3±2.6 versus 12.9±3.5 m L/100 m L)were significantly decreased in hypoperfused compared with normal segments,while TTP was increased in hypoperfused [14.5(13.1,15.9)seconds] compared with normal segments [9.0(7.6,10.8)seconds](all P values < 0.001).Area under the ROC curve of MBF and MBV for predicting normal myocardial perfusion were 0.891(95% CI: 0.855,0.927)and0.857(95% CI: 0.812,0.903),respectively,and area under the ROC curve of TTP for predicting myocardial perfusion defects was 0.877(95% CI: 0.834,0.919),all P values < 0.001.Conclusion The performance of stress dynamic CT-MPI in the diagnosis of myocardial perfusion defects in CAD was good,with high sensitivity and negative predictive value.Objective To assess effects of stress dynamic CT myocardial perfusion imaging(CT-MPI)combined with coronary CT angiography(CCTA)on the diagnosis of myocardial perfusion defects in coronary artery disease(CAD).Methods Patients suspected of having CAD underwent a combined ATP stress CT-MPI and CCTA examination.Nuclear myocardial perfusion imaging(NMPI)was performed within one week.CT-MPI results were qualitatively analyzed,and myocardial blood flow(MBF),myocardial blood volume(MBV)as well as time to peak(TTP)were quantified according to CT-MPI.Effects of CCTA,CT-MPI,and CT-MPI Combined With CCTA on predicting myocardial perfusion defects were assessed in comparison with NMPI.Results Twenty five patients were enrolled in our study.MBF [76.3(60.2,88.8)versus 127.4(105.5,159.1)m L/100 m L/min] and MBV(8.3±2.6 versus12.9±3.5 m L/100 m L)were significantly decreased in hypoperfused compared with normal segments,while TTP was increased in hypoperfused [14.5(13.1,15.9)seconds]compared with normal segments [9.0(7.6,10.8)seconds](all P values < 0.001).The sensitivity,specificity,positive predictive value,and negative predictive value of CT-MPI for identifying segments with perfusion defects were 0.964,0.836,0.588 and0.990,respectively.On a per-vessel basis,the area under the receiver operating characteristic curve for predicting myocardial perfusion defects were,respectively,0.858(0.770,0.947)for CCTA,0.859(0.769,0.949)for CT-MPI,and 0.896(0.818,0.973)for CT-MPI combined with CCTA.Conclusion The performance of stress dynamic CT-MPI in the diagnosis of myocardial perfusion defects in CAD was good.One-stop examination of CT-MPI combined with CCTA improves the diagnostic accuracy for identifying flow-obstructing stenosis. |
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