CT Assessment of the Myocardial Blood Supply: Quantitative Imaging

  • Chapter
  • First Online:
CT Imaging of Myocardial Perfusion and Viability

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 1298 Accesses

Abstract

Myocardial perfusion computed tomography (CTP) is a promising imaging technique on the verge of expanding the capabilities of CT. Especially, the capability of CTP to enable quantitative evaluations may provide a more accurate assessment of the hemodynamic significance of CAD. Two different approaches currently used are discussed in this chapter: 1. Dual energy CT 2. Dynamic, time-resolved quantitative imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Bamberg F, Klotz E, Flohr T, Becker A, Becker CR, Schmidt B, Wintersperger BJ, Reiser MF, Nikolaou K (2010) Dynamic myocardial stress perfusion imaging using fast dual-source CT with alternating table positions: initial experience. Eur Radiol 20(5):1168–1173. doi:10.1007/s00330-010-1715-9

    Article  PubMed  Google Scholar 

  • Bamberg F, Becker A, Schwarz F, Marcus RP, Greif M, von Ziegler F, Blankstein R, Hoffmann U, Sommer WH, Hoffmann VS, Johnson TRC, Becker H-CR, Wintersperger BJ, Reiser MF, Nikolaou K (2011) Detection of hemodynamically significant coronary artery stenosis: incremental diagnostic value of dynamic CT-based myocardial perfusion imaging. Radiology 260(3):689–698. doi:10.1148/radiol.11110638

    Article  PubMed  Google Scholar 

  • Bastarrika G, Ramos-Duran L, Rosenblum MA, Kang DK, Rowe GW, Schoepf UJ (2010) Adenosine-stress dynamic myocardial CT perfusion imaging: initial clinical experience. Invest Radiol 45(6):306–313. doi:10.1097/RLI.0b013e3181dfa2f2

    PubMed  CAS  Google Scholar 

  • Bischoff B, Bamberg F, Marcus R, Schwarz F, Becker HC, Becker A, Reiser M, Nikolaou K (2012) Optimal timing for first-pass stress CT myocardial perfusion imaging. Int J Cardiovasc Imaging. doi:10.1007/s10554-012-0080-y

    Google Scholar 

  • Brooks RA, Di Chiro G (1976) Beam hardening in X-ray reconstructive tomography. Phys Med Biol 21(3):390–398

    Article  PubMed  CAS  Google Scholar 

  • Cury RC, Nieman K, Shapiro MD, Butler J, Nomura CH, Ferencik M, Hoffmann U, Abbara S, Jassal DS, Yasuda T, Gold HK, Jang IK, Brady TJ (2008) Comprehensive assessment of myocardial perfusion defects, regional wall motion, and left ventricular function by using 64-section multidetector CT. Radiology 248(2):466–475. doi:10.1148/radiol.2482071478

    Article  PubMed  Google Scholar 

  • De Bruyne B, Pijls NHJ, Kalesan B, Barbato E, Tonino PAL, Piroth Z, Jagic N, Mobius-Winckler S, Rioufol G, Witt N, Kala P, MacCarthy P, Engstrøm T, Oldroyd KG, Mavromatis K, Manoharan G, Verlee P, Frobert O, Curzen N, Johnson JB, Jüni P, Fearon WF (2012) Fractional flow reserve–guided PCI versus medical therapy in stable coronary disease. New Engl J Med: 120827230013003. doi:10.1056/NEJMoa1205361

  • George RT, Silva C, Cordeiro MA, DiPaula A, Thompson DR, McCarthy WF, Ichihara T, Lima JA, Lardo AC (2006) Multidetector computed tomography myocardial perfusion imaging during adenosine stress. J Am Coll Cardiol 48(1):153–160. doi:10.1016/j.jacc.2006.04.014

    Article  PubMed  Google Scholar 

  • George RT, Jerosch-Herold M, Silva C, Kitagawa K, Bluemke DA, Lima JA, Lardo AC (2007) Quantification of myocardial perfusion using dynamic 64-detector computed tomography. Invest Radiol 42(12):815–822. doi:10.1097/RLI.0b013e318124a884

    Article  PubMed  Google Scholar 

  • Hamon M, Fau G, Née G, Ehtisham J, Morello R, Hamon M (2010) Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease. J Cardiovasc Magn Reson 12(1):29. doi:10.1186/1532-429X-12-29

    Article  PubMed  Google Scholar 

  • Kang DK, Schoepf UJ, Bastarrika G, Nance JW Jr, Abro JA, Ruzsics B (2010) Dual-energy computed tomography for integrative imaging of coronary artery disease: principles and clinical applications. Semin Ultrasound CT MR 31(4):276–291. doi:10.1053/j.sult.2010.05.004

    Article  PubMed  Google Scholar 

  • Leber AW, Johnson T, Becker A, von Ziegler F, Tittus J, Nikolaou K, Reiser M, Steinbeck G, Becker CR, Knez A (2007) Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur Heart J 28(19):2354–2360. doi:10.1093/eurheartj/ehm294

    Article  PubMed  Google Scholar 

  • Mahnken AH, Bruners P, Katoh M, Wildberger JE, Gunther RW, Buecker A (2006) Dynamic multi-section CT imaging in acute myocardial infarction: preliminary animal experience. Eur Radiol 16(3):746–752. doi:10.1007/s00330-005-0057-5

    Article  PubMed  Google Scholar 

  • Mahnken AH, Klotz E, Pietsch H, Schmidt B, Allmendinger T, Haberland U, Kalender WA, Flohr T (2010) Quantitative whole heart stress perfusion CT imaging as noninvasive assessment of hemodynamics in coronary artery stenosis: preliminary animal experience. Invest Radiol 45(6):298–305. doi:10.1097/RLI.0b013e3181dfa3cf

    PubMed  Google Scholar 

  • Nagao M, Matsuoka H, Kawakami H, Higashino H, Mochizuki T, Murase K, Uemura M (2008) Quantification of myocardial perfusion by contrast-enhanced 64-MDCT: characterization of ischemic myocardium. Am J Roentgenol 191(1):19–25. doi:10.2214/AJR.07.2929

    Article  Google Scholar 

  • Nance JW Jr, Bastarrika G, Kang DK, Ruzsics B, Vogt S, Schmidt B, Raupach R, Flohr TG, Schoepf UJ (2011) High-temporal resolution dual-energy computed tomography of the heart using a novel hybrid image reconstruction algorithm: initial experience. J Comput Assist Tomogr 35(1):119–125. doi:10.1097/RCT.0b013e3181f87475

    Article  PubMed  Google Scholar 

  • Nesto RW, Kowalchuk GJ (1987) The ischemic cascade: temporal sequence of hemodynamic, electrocardiographic and symptomatic expressions of ischemia. Am J Cardiol 59(7):23C–30C

    Article  PubMed  CAS  Google Scholar 

  • Nikolaou K, Sanz J, Poon M, Wintersperger BJ, Ohnesorge B, Rius T, Fayad ZA, Reiser MF, Becker CR (2005) Assessment of myocardial perfusion and viability from routine contrast-enhanced 16-detector-row computed tomography of the heart: preliminary results. Eur Radiol 15(5):864–871. doi:10.1007/s00330-005-2672-6

    Article  PubMed  Google Scholar 

  • Rumberger JA, Feiring AJ, Lipton MJ, Higgins CB, Ell SR, Marcus ML (1987) Use of ultrafast computed tomography to quantitate regional myocardial perfusion: a preliminary report. J Am Coll Cardiol 9(1):59–69

    Article  PubMed  CAS  Google Scholar 

  • Ruzsics B, Schwarz F, Schoepf UJ, Lee YS, Bastarrika G, Chiaramida SA, Costello P, Zwerner PL (2009) Comparison of dual-energy computed tomography of the heart with single photon emission computed tomography for assessment of coronary artery stenosis and of the myocardial blood supply. Am J Cardiol 104(3):318–326. doi:10.1016/j.amjcard.2009.03.051

    Article  PubMed  Google Scholar 

  • So A, Lee TY (2011) Quantitative myocardial CT perfusion: a pictorial review and the current state of technology development. J Cardiovasc Comput Tomogr 5(6):467–481. doi:10.1016/j.jcct.2011.11.002

    Article  PubMed  Google Scholar 

  • So A, Lee TY, Imai Y, Narayanan S, Hsieh J, Kramer J, Procknow K, Leipsic J, Labounty T, Min J (2011) Quantitative myocardial perfusion imaging using rapid kVp switch dual-energy CT: preliminary experience. J Cardiovasc Comput Tomogr 5(6):430–442. doi:10.1016/j.jcct.2011.10.008

    Article  PubMed  Google Scholar 

  • So A, Hsieh J, Imai Y, Narayanan S, Kramer J, Procknow K, Dutta S, Leipsic J, Min JK, Labounty T, Lee TY (2012) Prospectively ECG-triggered rapid kV-switching dual-energy CT for quantitative imaging of myocardial perfusion. JACC Cardiovasc Imaging 5(8):829–836. doi:10.1016/j.jcmg.2011.12.026

    Article  PubMed  Google Scholar 

  • Taylor AJ, Cerqueira M, Hodgson JMB, Mark D, Min J, O’gara P, Rubin GD (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. JAC 56(22):1864–1894. doi:10.1016/j.jacc.2010.07.005

    Google Scholar 

  • Tonino PAL, De Bruyne B, Pijls NHJ, Siebert U, Ikeno F, Van t Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, Fearon WF, Investigators FS (2009) Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. New Engl J Med 360(3):213–224. doi:10.1056/NEJMoa0807611

    Article  PubMed  CAS  Google Scholar 

  • Wang Y, Qin L, Shi X, Zeng Y, **g H, Schoepf UJ, ** Z (2012) Adenosine-stress dynamic myocardial perfusion imaging with second-generation dual-source CT: comparison with conventional catheter coronary angiography and SPECT nuclear myocardial perfusion imaging. Am J Roentgenol 198(3):521–529. doi:10.2214/AJR.11.7830

    Article  Google Scholar 

  • Wolfkiel CJ, Ferguson JL, Chomka EV, Law WR, Labin IN, Tenzer ML, Booker M, Brundage BH (1987) Measurement of myocardial blood flow by ultrafast computed tomography. Circulation 76(6):1262–1273

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ullrich Ebersberger .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Ebersberger, U., Silverman, J.R., Cho, Y.J., Geyer, L.L. (2013). CT Assessment of the Myocardial Blood Supply: Quantitative Imaging. In: Schoepf, U., Bamberg, F., Ruzsics, B., Vliegenthart, R., Bastarrika, G. (eds) CT Imaging of Myocardial Perfusion and Viability. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_773

Download citation

  • DOI: https://doi.org/10.1007/174_2012_773

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-33878-6

  • Online ISBN: 978-3-642-33879-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Navigation