Department of Radiology, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Radiology, Sungkyunkwan University School of Medicine, Seoul, Korea.
Medicine (Baltimore). 2022 Sep 9;101(36):e30477. doi: 10.1097/MD.0000000000030477.
Myocardial computed tomography perfusion (CTP) imaging is a noninvasive method for detecting myocardial ischemia. This study aimed to compare the diagnostic performance of dynamic and static adenosine-stress CTPs for detecting hemodynamically significant coronary stenosis. We prospectively enrolled 42 patients (mean age, 59.7 ± 8.8 years; 31 males) with ≥40% coronary artery stenosis. All patients underwent dynamic CTP for adenosine stress. The static CTP was simulated by choosing the seventh dynamic dataset after the initiation of the contrast injection. Diagnostic performance was compared with invasive fractional flow reserve (FFR) <0.8 as the reference. Of the 125 coronary vessels in 42 patients, 20 (16.0%) in 16 (38.1%) patients were categorized as hemodynamically significant. Dynamic and static CTP yielded similar diagnostic accuracy (90.4% vs 88.8% using visual analysis, P = .558; 77.6% vs 80.8% using quantitative analysis, P = .534; 78.4% vs 82.4% using combined visual and quantitative analyses, P = .426). The diagnostic accuracy of combined coronary computed tomography angiography (CCTA) and dynamic CTP (89.6% using visual analysis, P = .011; 88.8% using quantitative analysis, P = .018; 89.6% using combined visual and quantitative analyses, P = .011) and that of combined CCTA and static CTP (88.8% using visual analysis, P = .018; 90.4% using quantitative analysis, P = .006; 91.2% using combined visual and quantitative analyses, P = .003) were significantly higher than that of CCTA alone (77.6%). Dynamic CTP and static CTP showed similar diagnostic performance in the detection of hemodynamically significant stenosis.
心肌计算机断层灌注（CTP）成像 是一种用于检测心肌缺血的非侵入性方法。本研究旨在比较动态和静态腺苷应激 CTP 检测血流动力学显著冠状动脉狭窄的诊断性能。我们前瞻性纳入了 42 名（平均年龄 59.7±8.8 岁；31 名男性）≥40%冠状动脉狭窄的患者。所有患者均行腺苷负荷动态 CTP 检查。在对比剂注射开始后选择第七个动态数据集来模拟静态 CTP。将诊断性能与有创性血流储备分数（FFR）<0.8 作为参考进行比较。在 42 名患者的 125 个冠状动脉中，20 个（16.0%）在 16 个（38.1%）患者中被归类为血流动力学显著狭窄。动态和静态 CTP 的诊断准确性相似（视觉分析为 90.4%与 88.8%，P=.558；定量分析为 77.6%与 80.8%，P=.534；联合视觉和定量分析为 78.4%与 82.4%，P=.426）。联合冠状动脉计算机断层血管造影（CCTA）和动态 CTP 的诊断准确性（视觉分析为 89.6%，P=.011；定量分析为 88.8%，P=.018；联合视觉和定量分析为 89.6%，P=.011）和联合 CCTA 和静态 CTP（视觉分析为 88.8%，P=.018；定量分析为 90.4%，P=.006；联合视觉和定量分析为 91.2%，P=.003）明显高于 CCTA 单独检查（77.6%）。动态 CTP 和静态 CTP 在检测血流动力学显著狭窄方面具有相似的诊断性能。
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