Kouchi Takanori, Tanabe Yuki, Takemoto Takumasa, Yoshida Kazuki, Yamamoto Yuta, Miyazaki Shigehiro, Fukuyama Naoki, Nishiyama Hikaru, Inaba Shinji, Kawaguchi Naoto, Kido Tomoyuki, Yamaguchi Osamu, Kido Teruhito
Department of Radiology, Graduate School of Medicine, Ehime University, Shitsukawa, Toon 791-0295, Japan.
Department of Cardiology, Pulmonology, Hypertension and Nephrology, Graduate School of Medicine, Ehime University, Shitsukawa, Toon 791-0295, Japan.
J Clin Med. 2022 Mar 25;11(7):1816. doi: 10.3390/jcm11071816.
We evaluated the feasibility of myocardial perfusion ratio to the aorta (MPR) in static computed tomography perfusion (CTP) for detecting myocardial perfusion abnormalities assessed by single-photon emission computed tomography (SPECT). Twenty-five patients with suspected coronary artery disease who underwent dynamic CTP and SPECT were retrospectively evaluated. CTP images scanned at a sub-optimal phase for detecting myocardial perfusion abnormalities were selected from dynamic CTP images and used as static CTP images in the present study. The diagnostic accuracy of MPR derived from static CTP was compared to those of visual assessment and conventional quantitative parameters such as myocardial CT attenuation (HU) and transmural perfusion ratio (TPR). The area under the curve of MPR (0.84; 95% confidence interval [CI], 0.76−0.90) was significantly higher than those of myocardial CT attenuation (0.73; 95% CI, 0.65−0.79) and TPR (0.76; 95% CI, 0.67−0.83) (p < 0.05). Sensitivity and specificity were 67% (95% CI, 54−77%) and 90% (95% CI, 86−92%) for visual assessment, 51% (95% CI, 39−63%) and 86% (95% CI, 82−89%) for myocardial CT attenuation, 63% (95% CI, 51−74%) and 84% (95% CI, 80−88%) for TPR, and 78% (95% CI, 66−86%) and 84% (95% CI, 80−88%) for MPR, respectively. MPR showed higher diagnostic accuracy for detecting myocardial perfusion abnormality compared with myocardial CT attenuation and TPR.
我们评估了在静态计算机断层扫描灌注（CTP）中，心肌与主动脉灌注比（MPR）用于检测单光子发射计算机断层扫描（SPECT）评估的心肌灌注异常的可行性。对25例接受动态CTP和SPECT检查的疑似冠心病患者进行回顾性评估。从动态CTP图像中选择在检测心肌灌注异常时处于次优期扫描的CTP图像，并在本研究中用作静态CTP图像。将静态CTP得出的MPR的诊断准确性与视觉评估以及传统定量参数（如心肌CT衰减（HU）和透壁灌注比（TPR））的诊断准确性进行比较。MPR的曲线下面积（0.84；95%置信区间[CI]，0.76−0.90）显著高于心肌CT衰减（0.73；95%CI，0.65−0.79）和TPR（0.76；95%CI，0.67−0.83）（p<0.05）。视觉评估的敏感性和特异性分别为67%（95%CI，54−77%）和90%（95%CI，86−92%），心肌CT衰减的敏感性和特异性分别为51%（95%CI，39−63%）和86%（95%CI，82−89%），TPR的敏感性和特异性分别为63%（95%CI，51−74%）和84%（95%CI，80−88%），MPR的敏感性和特异性分别为78%（95%CI，66−86%）和84%（95%CI，80−88%）。与心肌CT衰减和TPR相比，MPR在检测心肌灌注异常方面显示出更高的诊断准确性。
