Cardiac CT emerging role in myocardial perfusion evaluation.

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-0956

Type:

Educational Exhibit

Keywords:

Cardiac, Cardiovascular system, Arteries / Aorta, CT, CT-Angiography, CT-Quantitative, Computer Applications-3D, Diagnostic procedure, Ischaemia / Infarction, Arteriosclerosis

Authors:

S. Seitun¹, S. Boccalini¹, I. Budaj¹, M. Castiglione Morelli¹, A. Galletto², C. Zawaideh¹, I. Rota¹, F. Cademartiri³, C. Ferro¹; ¹Genoa/IT, ²Borgio Verezzi/IT, ³Monastier di Treviso/IT

DOI:

10.1594/ecr2015/C-0956

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-0956

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Learning objectives

Evaluate the emerging role of dynamic myocardial perfusion assessment with CT, in patients with suspected ischemic cardiomyopathy, identifying: - Ischemic perfusion defects highlighted in stress conditions and reversible in rest conditions - Fixed ischemic perfusion defects (necrosis-fibrosis areas)

Background

Up to today CT is the most accurate examination for a non-invasive assessment of coronary atherosclerosis, however, based on anatomic-morphologic characteristics only, it’s not possible to determine the physiopathological meaning of a coronary atherosclerotic plaque. As shown in studies with invasive measurement of the coronary fractional flow reserve obtained during coronarography [1], the downstream perfusion alteration of an intermediate coronary stenosis (40-70% of lumen restriction) can be uncertain. For these reasons, in clinical practice, morphologic informations regarding the coronary arteries acquired with coronary-CT are often...

Findings and procedure details

EXAMINATION TECHNIQUE Through a revision of the literature we present our case series of examinations acquired with a second generation dual-source 128 slice CT scan (Somatom Definition Flash, Siemens, Erlangen, Germania). The protocol includes several acquisitions. After the patient has been elucidated regarding the procedure and an informed consent has been obtained, a pre-contrast scan is acquired (Calcium Score) in order to plan the exact range for the following steps. A vasodilator drug able to induce myocardial ischemia is administered for the successive acquisition in...

Conclusion

Cardiac CT perfusion imaging is a promising technique able to lead to an improvement of the diagnostic accuracy and especially of the specificity of cardiac CT examinations, by combining morphological and functional data obtained in the same examination.

Personal information

References

1. Tonino PAL, Fearon WF, De Bruyne B, Oldroyd KG, Leesar MA, Ver Lee PN, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol 2010;55:2816–21. 2. Rossi A, Merkus D, Klotz E, Mollet N, de Feyter PJ, Krestin GP. Stress myocardial perfusion: imaging with multidetector CT. Radiology. 2014 Jan;270(1):25-46. 3. Techasith T, BS, Cury RC. Stress Myocardial CT Perfusion: an Update and Future Perspective. JACC Cardiovasc Imaging. 2011...