Quantitative evaluation of regional myocardial perfusion using fast x-ray computed tomography

被引:21
作者
Schmermund, A
Bell, MR
Lerman, LO
Ritman, EL
Rumberger, JA
机构
[1] MAYO CLIN & MAYO FDN, DEPT CARDIOVASC DIS & INTERNAL MED, ROCHESTER, MN 55905 USA
[2] MAYO CLIN & MAYO FDN, DEPT PHYSIOL & BIOPHYS, ROCHESTER, MN 55905 USA
关键词
D O I
10.1007/BF03044568
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Clinical quantitation of regional myocardial perfusion using a minimally invasive and easily applied technique could allow for ready quantitation of the functional significance of coronary disease, allow for further understanding of flow reserve in various cardiomyopathic and hemodynamic overload (pressure versus volume) conditions, and possibly provide basic information needed regarding the development and clinical significance of coronary collateral vessels and diseases of the myocardial microcirculation. Electron beam CT (EBCT) is a unique cardiac imaging modality that allows for rapid acquisition tomographic slices of the heart with excellent spatial resolution. It has been demonstrated to provide accurate measurements of cardiac anatomy, biventricular function, myocardial mass, and estimates of mural atherosclerotic plaque burden via quantification of coronary calcium. The application of classical indicator techniques for use by fast x-ray computed tomography techniques such as electron beam CT has been shown to allow quantitative analysis of regional myocardial perfusion throughout the myocardium. Initial studies using central intravenous contrast injection in experimental animals showed a close correlation of regional myocardial perfusion as quantitated by electron beam CT with measurements using radiolabeled microspheres at resting and moderately increased now states. At high now states, however, electron beam CT significantly underestimated absolute myocardial perfusion and thus myocardial now reserve. Using another fast CT device, the Dynamic Spatial Reconstructor (DSR), concepts of intramyocardial vascular blood volume and its relation to myocardial now have been established. By adapting these concepts to electron beam CT scanning and accounting for the increase in intramyocardial vascular blood volume at vasodilatation, the ability to correctly quantitate perfusion states up to approximately 400 mt . min(-1) . 100 g(-1) using central intravenous contrast administration was demonstrated. This implies that studies can be done with intravenous injection methods for characterization of regional myocardial perfusion up to the normal flow reserve of approximately 4.1. Important physiologic and clinical abnormalities in flow reserve generally result in a ratio < 3:1. Electron beam CT offers the capability to quantitate regional myocardial perfusion in both the clinical and research setting. Of particular interest is the ability to provide quantitative regional myocardial perfusion which can be coupled to the evaluation of cardiac anatomy and function as well as mural coronary atherosclerotic calcium burden during the same scanning session. Thus, electron beam CT has the potential to become a valuable, minimally invasive clinical tool for comprehensive analysis of cardiac function and coronary status.
引用
收藏
页码:29 / 39
页数:11
相关论文
共 30 条
[1]  
BAUMGART D, IN PRESS J AM COLL C
[2]  
BELL MR, 1991, CIRCULATION, V84, P678
[3]  
BOYD DP, 1983, CT HEART GREAT VESSE, P45
[4]  
Erbel R, 1996, EUR HEART J, V17, P880
[5]   DETERMINATION OF LEFT-VENTRICULAR MASS IN DOGS WITH RAPID-ACQUISITION CARDIAC COMPUTED TOMOGRAPHIC SCANNING [J].
FEIRING, AJ ;
RUMBERGER, JA ;
REITER, SJ ;
SKORTON, DJ ;
COLLINS, SM ;
LIPTON, MJ ;
HIGGINS, CB ;
ELL, S ;
MARCUS, ML .
CIRCULATION, 1985, 72 (06) :1355-1364
[6]   SECTIONAL AND SEGMENTAL VARIABILITY OF LEFT-VENTRICULAR FUNCTION - EXPERIMENTAL AND CLINICAL-STUDIES USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].
FEIRING, AJ ;
RUMBERGER, JA ;
REITER, SJ ;
COLLINS, SM ;
SKORTON, DJ ;
REES, M ;
MARCUS, ML .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (02) :415-425
[7]   MEASUREMENT OF CARDIAC-OUTPUT BY CINE COMPUTED-TOMOGRAPHY [J].
GARRETT, JS ;
LANZER, P ;
JASCHKE, W ;
BOTVINICK, E ;
SIEVERS, R ;
HIGGINS, CB ;
LIPTON, MJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1985, 56 (10) :657-661
[8]   PICTURE QUALITY OF COMPUTED TOMOGRAPHY [J].
HOUNSFIELD, GN .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1976, 127 (01) :3-9
[9]   MEASUREMENT OF ABSOLUTE MYOCARDIAL BLOOD-FLOW WITH (H2O)-O-15 AND DYNAMIC POSITRON-EMISSION TOMOGRAPHY - STRATEGY FOR QUANTIFICATION IN RELATION TO THE PARTIAL-VOLUME EFFECT [J].
IIDA, H ;
KANNO, I ;
TAKAHASHI, A ;
MIURA, S ;
MURAKAMI, M ;
TAKAHASHI, K ;
ONO, Y ;
SHISHIDO, F ;
INUGAMI, A ;
TOMURA, N ;
HIGANO, S ;
FUJITA, H ;
SASAKI, H ;
NAKAMICHI, H ;
MIZUSAWA, S ;
KONDO, Y ;
UEMURA, K .
CIRCULATION, 1988, 78 (01) :104-115
[10]   FLOW MEASUREMENTS WITH A HIGH-SPEED COMPUTED-TOMOGRAPHY SCANNER [J].
JASCHKE, W ;
GOULD, RG ;
ASSIMAKOPOULOS, PA ;
LIPTON, MJ .
MEDICAL PHYSICS, 1987, 14 (02) :238-243