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Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography

European Radiology volume 21, pages 26–35 (2011)Cite this article

Abstract

Objective

To evaluate the feasibility and diagnostic accuracy of adenosine-stress dual-energy computed tomography (DECT) for detecting haemodynamically significant stenosis causing reversible myocardial perfusion defect (PD) compared with stress perfusion magnetic resonance imaging (SP-MRI) and conventional coronary angiography (CCA).

Methods

Fifty patients with known coronary artery disease (CAD) detected by dual-source CT (DSCT) were investigated by contrast-enhanced, stress DECT with high- and low-energy x-ray spectra settings during adenosine infusion. A colour-coded iodine map was used for evaluation of myocardial PDs compared with rest DSCT perfusion images. Reversible myocardial PDs according to the stress DECT/rest DSCT were compared with SP-MRI on a segmental basis and CCA on a vascular territorial basis.

Results

A total of 697 myocardial segments and 123 vascular territories of 41 patients were analysed. Three hundred one segments and 72 vascular territories in 38 patients showed reversible PDs on stress DECT. Stress DECT had 89% sensitivity, 78% specificity and 82% accuracy for detecting segments with reversible PDs seen on SP-MRI (n = 28). Compared with CCA (n = 41), stress DECT had 89% sensitivity, 76% specificity and 83% accuracy for the detection of vascular territories with reversible myocardial PDs that had haemodynamically relevant CAD.

Conclusion

Adenosine stress DECT can identify stress-induced myocardial PD in patients with CAD.

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Acknowledgements

This work was supported by Konkuk University in 2010. The authors would like to thank the CT and MR technologists, the radiology department nursing staff, the cardiology department staff physicians and the residents in the Division of Thoracic Surgery at the Konkuk University Hospital.

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Affiliations

  1. Department of Radiology, Konkuk University Hospital, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea

    Sung Min Ko & Jin Woo Choi

  2. Department of Thoracic surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    Meong Gun Song, Je Kyoun Shin & Hyun Kun Chee

  3. Department of Nuclear medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea

    Hyun Woo Chung

  4. Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, College of Medicine, Seoul, Korea

    Dong Hun Kim

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  1. Sung Min Ko
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Correspondence to Sung Min Ko.

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Ko, S.M., Choi, J.W., Song, M.G. et al. Myocardial perfusion imaging using adenosine-induced stress dual-energy computed tomography of the heart: comparison with cardiac magnetic resonance imaging and conventional coronary angiography. Eur Radiol 21, 26–35 (2011). https://doi.org/10.1007/s00330-010-1897-1

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  • DOI: https://doi.org/10.1007/s00330-010-1897-1

Keywords

  • Computed tomography (CT)
  • Coronary artery disease
  • Dual-energy CT
  • Ischaemia
  • Myocardial perfusion