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Quantitative myocardial perfusion analysis using multi-row detector CT in acute myocardial infarction
  1. Yoshifumi Nakauchi1,
  2. Yoshitaka Iwanaga1,
  3. Shinichiro Ikuta1,
  4. Masayuki Kudo2,3,
  5. Kazuhiro Kobuke1,
  6. Takamichi Murakami4,
  7. Shunichi Miyazaki1
  1. 1Division of Cardiology, Department of Internal Medicine, Kinki University Faculty of Medicine, Osakasayama, Japan
  2. 2Imaging Application Tech Center, GE Healthcare Japan, Hino, Japan
  3. 3Department of Anatomy and Neurobiology, Kinki University Graduate School of Medicine, Osakasayama, Japan
  4. 4Department of Radiology, Kinki University Faculty of Medicine, Osakasayama, Japan
  1. Correspondence to Professor Shunichi Miyazaki, Division of Cardiology, Department of Internal Medicine, Kinki University Faculty of Medicine. 377-2 Ohno-Higashi, Osakasayama 589-8511, Japan; smiyazak{at}med.kindai.ac.jp

Abstract

Objective To assess the feasibility of quantitative myocardial perfusion imaging (MPI) in acute myocardial infarction (AMI), using multi-row detector CT (MDCT) with a model-based deconvolution method.

Design, setting, patients and interventions Fifteen normal subjects with normal coronary arteries and 26 patients with AMI after reperfusion therapy underwent MPI with MDCT. Perfusion parameters: tissue blood flow (TBF), tissue blood volume (TBV) and mean transit time (MTT) were obtained and compared with clinical parameters, angiography and single-photon emission CT (SPECT) data. Furthermore, the MPI data were compared with data from myocardial magnetic resonance (MR) in 10 subjects.

Results The TBF and TBV of infarcted myocardium were significantly lower than those of non-infarcted areas (TBF, 51.96±19.42 vs 108.84±13.29 ml/100 g/min, p<0.01; TBV, 4.47±2.23 vs 9.79±2.58 ml/100 g, p<0.01). The MTT of infarcted areas did not differ from that of non-infarcted areas. The defect areas on TBV colour maps were significantly associated with peak creatine kinase level, QRS score and SPECT defect score. The ratio of TBF or TBV in the epicardial to endocardial side was significantly higher in infarct myocardium with good collateral circulation than in myocardium with poor/no collateral circulation (p<0.01 for both). The TBF measurements with CT- and MR-MPI were in good agreement by linear regression analysis (R=0.55, p<0.01).

Conclusions This study demonstrated that MDCT perfusion imaging with deconvolution analysis could quantitatively detect myocardial perfusion abnormalities in patients with AMI and may provide the basis for the non-invasive and quantitative assessment of myocardial infarction.

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Footnotes

  • Yoshifumi Nakauchi and Yoshitaka Iwanaga contributed equally to this work.

  • Funding SM received research support from Daiichi-Sankyo Pharmaceutical Co.,Ltd., Eisai Co.,Ltd., Sanofi-Aventis K.K., and Shionogi & Co.,Ltd., but they played no role in conception, conduct or analysis of this study.

  • Competing interests MK is an employee of GE Healthcare.

  • Patient consent Obtained.

  • Ethics approval Approved by an institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed

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