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Myocardial hypo-enhancement on resting computed tomography angiography images accurately identifies myocardial hypoperfusion.

Abstract：

OBJECTIVE:The objective of this study was to test the diagnostic accuracy of myocardial CT perfusion (CTP) imaging using color and gray-scale image analysis. BACKGROUND:Current myocardial CTP techniques have varying diagnostic accuracy and are prone to artifacts that impair detection. This study evaluated the diagnostic accuracy of color and/or gray-scale CTP and the application of artifact criteria to detect hypoperfusion. METHODS:Fifty-nine prospectively enrolled patients with abnormal single-photon emission computed tomography (SPECT) studies were analyzed. True hypoperfusion was defined if SPECT hypoperfusion corresponded to obstructive coronary stenoses on CT angiography (CTA). CTP applied color and gray-scale myocardial perfusion maps to resting CTA images. Criteria for identifying artifacts were also applied during interpretation. RESULTS:Using combined SPECT plus CTA as the diagnostic standard, abnormal myocardial CTP was present in 33 (56%) patients, 19 suggesting infarction and 14 suggesting ischemia. Patient-level color and gray-scale myocardial CTP sensitivity to detect infarction was 90%, with specificity 80%, and negative and positive predictive value of 94% and 68%. To detect ischemia or infarction, CTP specificity and positive predictive value were 92% whereas sensitivity was 70%. Gray-scale myocardial CTP had slightly lower specificity but similar sensitivity. Myocardial CTP artifacts were present in 88% of studies and were identified using our criteria. CONCLUSIONS:Color and gray-scale myocardial CTP using resting CTA images identified myocardial infarction with high sensitivity as well as infarction or ischemia with high specificity and positive predictive value without additional testing or radiation. Color and gray-scale CTP had slightly better specificity than gray-scale alone.

journal_name

J Cardiovasc Comput Tomogr

journal_title

Journal of cardiovascular computed tomography

authors

Busch JL,Alessio AM,Caldwell JH,Gupta M,Mao S,Kadakia J,Shuman W,Budoff MJ,Branch KR

doi

10.1016/j.jcct.2011.10.006

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

412-20

issue

eissn

1934-5925

issn

1876-861X

pii

S1934-5925(11)00374-1

journal_volume

pub_type

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Myocardial hypo-enhancement on resting computed tomography angiography images accurately identifies myocardial hypoperfusion.