De Geer Jakob, Gjerde Marcus, Brudin Lars, Olsson Eva, Persson Anders, Engvall Jan
Faculty of Health Sciences, Department of Medical and Health Sciences, Department of Radiology in Linköping, Center for Medical Image Science and Visualization (CMIV), Linköping University, County Council of Östergötland, Linköping, Sweden.
Faculty of Health Sciences, Department of Medical and Health Sciences, Department of Cardiology in Linköping, Center for Medical Image Science and Visualization (CMIV), Linköping University, County Council of Östergötland, Linköping, Sweden.
Clin Physiol Funct Imaging. 2015 Jul;35(4):291-300. doi: 10.1111/cpf.12163. Epub 2014 May 19.
Dynamic cardiac CT perfusion (CTP) is based on repeated imaging during the first-pass contrast agent inflow. It is a relatively new method that still needs validation.
To evaluate the variation in adenosine stress dynamic CTP blood flow as compared to (99m) Tc SPECT. Secondarily, to compare manual and automatic segmentation.
Seventeen patients with manifest coronary artery disease were included. Nine were excluded from evaluation for various reasons. All patients were examined with dynamic stress CTP and stress/rest SPECT. CTP blood flow was compared with SPECT on a per segment basis. Results for manual and automated AHA segmentation were compared.
CTP showed a positive correlation with SPECT, with correlation coefficients of 0·38 and 0·41 for manual and automatic segmentation, respectively (P<0·0001). There was no significant difference between the correlation coefficients of the manual and automated segmentation procedures (P = 0·75). The average per individual global CTP blood flow value for normal segments varied by a factor of 1·9 (manual and automatic segmentation). For the whole patient group, the CTP blood flow value in normal segments varied by a factor of 2·9/2·7 (manual/automatic segmentation). Within each patient, the average per segment blood flow in normal segments varied by a factor of 1·3-2·0/1·2-2·1 (manual/automatic segmentation).
A positive but rather weak correlation was found between CTP and (99m) Tc SPECT. Large variations in CTP blood flow suggest that a cut-off value for stress myocardial blood flow is inadequate to detect ischaemic segments. Dynamic CTP is hampered by a limited coverage.
动态心脏CT灌注成像（CTP）基于首次通过造影剂流入期间的重复成像。这是一种仍需验证的相对较新的方法。
评估腺苷负荷动态CTP血流与（99m）Tc单光子发射计算机断层显像（SPECT）相比的变化。其次，比较手动分割和自动分割。
纳入17例有明显冠状动脉疾病的患者。9例因各种原因被排除在评估之外。所有患者均接受动态负荷CTP和负荷/静息SPECT检查。逐节段比较CTP血流与SPECT。比较手动和自动美国心脏协会（AHA）分割的结果。
CTP与SPECT呈正相关，手动分割和自动分割的相关系数分别为0.38和0.41（P<0.0001）。手动和自动分割程序的相关系数之间无显著差异（P = 0.75）。正常节段的个体平均整体CTP血流值相差1.9倍（手动和自动分割）。对于整个患者组，正常节段的CTP血流值相差2.9/2.7倍（手动/自动分割）。在每个患者中，正常节段的每节段平均血流相差1.3 - 2.0/1.2 - 2.1倍（手动/自动分割）。
CTP与（99m）Tc SPECT之间存在正相关但较弱。CTP血流的较大差异表明，负荷心肌血流的截断值不足以检测缺血节段。动态CTP受到覆盖范围有限的阻碍。
