Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467-2490, USA.
J Cardiovasc Comput Tomogr. 2011 Jan-Feb;5(1):52-60. doi: 10.1016/j.jcct.2010.11.003. Epub 2010 Nov 26.
Computed tomography (CT) of the heart is increasingly used to characterize not only the coronary arteries but also cardiac structure and function. The performance of CT in depicting myocardial perfusion is under active investigation.
We describe the pattern of normal myocardial perfusion on resting 64-detector cardiac CT.
Patients (n = 33; 20 women, 13 men; mean age, 52 years) with normal radionuclide myocardial perfusion imaging and normal coronary arteries on CT angiography (120 kVp) comprised the study population. Segmental myocardial perfusion on CT was measured in Hounsfield units (HU) with manual and semiautomated methods for the 17-segment American Heart Association model in both systole and diastole. Segments were aggregated into coronary artery territories, from apex to base and by myocardial wall. The relationships between myocardial perfusion and various patient factors were evaluated.
Overall mean myocardial perfusion was 98 HU in systole and 94 HU in diastole with the manual method (P = .011) and 92 HU in systole and 95 HU in diastole with the automated method (P = .001). The septum showed significantly higher mean attenuation values than the other walls in systole and diastole with both methods. Generally, attenuation values were lower in the left circumflex artery territory and in the apex. Bivariate analysis showed higher mean myocardial attenuation values for women than men, although this difference did not persist on multivariate analysis adjusted for patient size.
Normal mean resting myocardial perfusion correlates with CT attenuation values of approximately 92-98 HU on CT angiography in the coronary arterial phase. The septum consistently shows greater attenuation values than the other walls.
心脏计算机断层扫描（CT）不仅越来越多地用于描绘冠状动脉，还用于描绘心脏结构和功能。CT 显示心肌灌注的性能正在积极研究中。
我们描述静息状态下 64 排心脏 CT 正常心肌灌注的模式。
研究人群包括 33 例（20 名女性，13 名男性；平均年龄 52 岁）患者，他们的放射性核素心肌灌注成像正常，CT 血管造影（120 kVp）显示冠状动脉正常。采用手动和半自动方法，以 17 节段美国心脏协会模型，在收缩期和舒张期测量 CT 上的节段性心肌灌注，以亨氏单位（HU）表示。将节段按冠状动脉分布区域、从心尖到基底以及心肌壁进行分组。评估了心肌灌注与各种患者因素之间的关系。
整体平均心肌灌注值分别为手动方法下收缩期 98 HU 和舒张期 94 HU（P =.011），自动方法下收缩期 92 HU 和舒张期 95 HU（P =.001）。在收缩期和舒张期，与其他壁相比，室间隔的平均衰减值明显较高，两种方法均如此。一般来说，左回旋支分布区域和心尖处的衰减值较低。双变量分析显示，女性的平均心肌衰减值高于男性，但在调整患者体型的多变量分析中，这种差异并不存在。
正常静息状态下的平均心肌灌注与冠状动脉期 CT 血管造影上的 CT 衰减值约为 92-98 HU 相关。室间隔的衰减值始终高于其他壁。
