Detection of significant stenosis in the Left Anterior Descending Artery by %26apos;Virtual Myocardial Perfusion%26apos; Bolus Tracking, 320 Slice Computed Tomography

作者：Takaoka Hiroyuki; Funabashi Nobusada^*; Fujimoto Yoshihide; Kobayashi Yoshio

来源：International Journal of Cardiology, 2014, 177(3): 1001-1007.

DOI：10.1016/j.ijcard.2014.09.141

• Significant stenosis
• Left Anterior Descending Artery
• Virtual myocardial perfusion bolus tracking
• 320 Slice Computed Tomography

Purpose: We used bolus-tracking CT-images, which are usually used only to detect contrast-material in target organs for optimal-starting of acquisition, as virtual first pass myocardial perfusion images. %26lt;br%26gt;Methods: Retrospective-analysis of 14 patients (10 male, 63 +/- 10 years) diagnosed with %26gt;= 75% stenosis confined to left-anterior-descending-artery (LAD) (7 patients, Group-1) or insignificant stenosis of any coronary artery (7 patients Group-2) diagnosed using invasive-coronary-angiograms (ICA) and enhanced 320-slice-CT within 3-months and without incident between examinations. Bolus-tracking CT-images were acquired at mid-level left-ventricle (LV) until CT-attenuation of descending-aorta increased to 200HU. We measured CT-attenuation (HU) in the LV anterior-wall (AW), the basal inter-ventricular-septum (BIVS), and LV basal lateral-wall (BLW) in end-systole using both bolus-tracking images and routine, enhanced, early-phase CT-images. %26lt;br%26gt;Results: In the bolus-tracking images, the Group-1 LV AW, BIVS, BLW CT-attenuation and ratio of LV AW CT attenuation to the average of BIVS and BLW were 36 +/- 7HU, 62 +/- 11HU, 58 +/- 25HU, and 0.6 +/- 0.1 respectively. In Group-2, they were 53 +/- 14HU, 56 +/- 9HU, 54 +/- 15HU, and 1.0 +/- 0.3 respectively. LV AW CT-attenuation and the ratio of LV AW CT values to the average of BIVS and BLW, were significantly lower in Group-1 (both P %26lt; 0.05). These values were not significant using routine, enhanced, early-phase CT-images. %26lt;br%26gt;Conclusions: Bolus-tracking CT-imagesmay be useful to detect the LAD-confined stenosis that cannot be detected using routine, enhanced, early-phase CT-images. This can be achieved by measuring the local-reduction in CT-attenuation of the LV AW compared with the average of those of the BIVS and BLW and without the need for drugs, exercise or additional radiation-exposure.

• 出版日期2014-12-20