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Patterns of myocardial perfusion in humans evaluated with contrast-enhanced 320 multidetector computed tomography

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Abstract

Left ventricular (LV) myocardial contrast enhancement can be recorded using 320 multi detector computed tomography (MDCT). We aimed to (1) assess patterns of regional myocardial perfusion at rest and compare them with NH3 positron emission tomography (PET) (2) and to assess the effect of intravenous adenosine infusion on regional myocardial perfusion. To evaluate myocardial perfusion patterns at rest, we scanned 14 healthy subjects with PET and 14 age and gender matched subjects with 320 MDCT. To evaluate the effect of adenosine stress on relative perfusion patterns 14 subjects with near-normal epicardial coronary arteries were studied at rest and during adenosine stress. Relative perfusion was assessed as attenuation density (AD) in 16 segments of the LV, and each segment was divided into 3 layers: endo-, mid- and epi-cardial. During rest the relative AD by MDCT was lower in the lateral wall compared with the remainder of the LV (P < 0.002). A similar pattern was found by PET-imaging. LV endocardial AD was higher than mid- and epicardial AD (P < 0.05). At rest the endocardial/epicardial ratio in the septum was 0.99 compared with 1.23 in non-septal segments (P < 0.001). During adenosine infusion transmural AD increased due to significant increases in the mid- and epicardium and the endocardial/epicardial ratio decreased by 18% in non-septal segments (from 1.23 to 1.05 P < 0.001). Relative perfusion at rest is lower in the lateral wall of the LV with both PET and MDCT compared to the remainder of the myocardium. During adenosine stress endocardial/epicardial ratio decrease significantly.

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Acknowledgments

Research radiographer Tina Bock-Pedersen and research nurse Kristina Molge are thanked for excellent technical assistance.

Conflict of interest

Dr Kofoed has received lecture fees from Toshiba Medical Systems Corporation. Dr. George has received research support from Astellas Pharma US, Inc. and Toshiba Medical Systems Corporation. Dr. George is a consultant for ICON Medical Imaging. The terms of these arrangements are managed by Johns Hopkins University in accordance with its conflict of interest policies.

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Authors and Affiliations

  1. Department of Cardiology, 2012, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark

    J. Tobias Kühl, Andreas Fuchs, Henning Kelbæk & Klaus Fuglsang Kofoed

  2. Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark

    Jesper J. Linde & Jens D. Hove

  3. Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

    Thomas S. Kristensen & Klaus Fuglsang Kofoed

  4. Department of Medicine, Johns Hopkins University, Baltimore, MD, USA

    Richard T. George

Authors
  1. J. Tobias Kühl
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  2. Jesper J. Linde
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  3. Andreas Fuchs
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  4. Thomas S. Kristensen
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  5. Henning Kelbæk
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  6. Richard T. George
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  7. Jens D. Hove
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  8. Klaus Fuglsang Kofoed
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Correspondence to J. Tobias Kühl.

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Kühl, J.T., Linde, J.J., Fuchs, A. et al. Patterns of myocardial perfusion in humans evaluated with contrast-enhanced 320 multidetector computed tomography. Int J Cardiovasc Imaging 28, 1739–1747 (2012). https://doi.org/10.1007/s10554-011-9986-z

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  • DOI: https://doi.org/10.1007/s10554-011-9986-z

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