Kawakubo Masateru, Tezuka Sana, Nagao Michinobu, Yamamoto Atsushi, Kaimoto Yoko, Nakao Risako, Tsutsui Yuji, Matsuo Yuka, Kaneko Koichiro, Sakai Akiko, Sakai Shuji
Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Health Sciences, School of Medicine, Kyushu University, Fukuoka, Japan.
EJNMMI Rep. 2025 Sep 8;9(1):32. doi: 10.1186/s41824-025-00265-5.
Because the myocardium thickness and blood flow of the right ventricular (RV) are lower than those of the left ventricle, it is challenging to perceive the RV myocardium in normal individuals. This study aimed to measure the myocardial perfusion in the RV (myocardial blood flow [MBF], myocardial flow reserve [MFR]) from 13N-ammonia PET images and investigate the associations between the MBF and MFR in patients with and without coronary artery disease (CAD) in the right coronary artery (RCA) region. A total 121 MBF and MFR were retrospectively measured from PET images by referring to the radioactivity and clinical blood flow values of the left ventricle. Adenosine-stressed and resting MBF and MFR were statistically compared among patients with RCA-MFR < 2.0 (group 1 [n = 61]), without RCA-MFR < 2.0 but with reduced MBF (group 2 [n = 16]), and without MFR < 2.0 (group 3 [n = 44]) using one-way analysis of variance with Tukey or Dunn post hoc analyses.
Stress MBF was lower in Group 1 than in Group 3, whereas resting MBF was higher in Group 1 than in Group 3. MFR gradually decreased from Group 3 to Group 1.
This study demonstrated the potential clinical applications of RV myocardial perfusion imaging using PET data. Our results highlight the importance of evaluating the MBF, particularly in patients with CAD. In CAD cases, the MFR was significantly reduced, with a more pronounced decrease, reflecting the severity of the disease. Additionally, increased resting MBF in patients with CAD may indicate compensatory mechanisms or microcirculatory disorders. These findings provide a foundation for further exploration of MBF and support the development of robust automated processing techniques to enhance clinical applicability.
由于右心室（RV）的心肌厚度和血流量低于左心室，因此在正常个体中检测右心室心肌具有挑战性。本研究旨在通过13N-氨PET图像测量右心室的心肌灌注（心肌血流量[MBF]、心肌血流储备[MFR]），并研究右冠状动脉（RCA）区域有无冠状动脉疾病（CAD）患者的MBF与MFR之间的关联。通过参考左心室的放射性和临床血流值，从PET图像中回顾性测量了总共121个MBF和MFR。使用单因素方差分析及Tukey或Dunn事后分析，对RCA-MFR<2.0的患者（第1组[n = 61]）、无RCA-MFR<2.0但MBF降低的患者（第2组[n = 16]）和无MFR<2.0的患者（第3组[n = 44]）的腺苷负荷和静息MBF及MFR进行统计学比较。
第1组的负荷MBF低于第3组，而第1组的静息MBF高于第3组。MFR从第3组到第1组逐渐降低。
本研究证明了使用PET数据进行右心室心肌灌注成像的潜在临床应用价值。我们的结果强调了评估MBF的重要性，尤其是在CAD患者中。在CAD病例中，MFR显著降低，且降低更为明显，反映了疾病的严重程度。此外，CAD患者静息MBF增加可能表明存在代偿机制或微循环障碍。这些发现为进一步探索MBF奠定了基础，并支持开发强大的自动化处理技术以提高临床适用性。
