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Pelgrim GJ, Duguay TM, Stijnen JMA, Varga-Szemes A, Van Tuijl S, Schoepf UJ, Oudkerk M, Vliegenthart R. Analysis of myocardial perfusion parameters in an ex-vivo porcine heart model using third generation dual-source CT. J Cardiovasc Comput Tomogr 2017; 11:141-147. [PMID: 28202246 DOI: 10.1016/j.jcct.2017.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the relationship between fractional flow reserve (FFR)-determined coronary artery stenosis severity and myocardial perfusion parameters derived from dynamic myocardial CT perfusion imaging (CTP) in an ex-vivo porcine heart model. METHODS Six porcine hearts were perfused according to Langendorff. Circulatory parameters such as arterial blood flow (ABF) (L/min), mean arterial pressure (MAP) (mmHg) and heart rate (bpm) were monitored. Using an inflatable cuff and monitored via a pressure wire, coronary artery stenoses of different FFR grades were created (no stenosis, FFR = 0.80, FFR = 0.70, FFR = 0.60, and FFR = 0.50). Third generation dual-source CT was used to perform dynamic CTP in shuttle mode at 70 kV. Using the AHA-16-segment model, myocardial blood flow (MBF) (mL/100 mL/min) and volume (MBV) (mL/100 mL) were analyzed using dedicated software for all ischaemic and non-ischaemic segments. RESULTS During five successful experiments, ABF ranged from 0.8 to 1.2 L/min, MAP from 73 to 90 mmHg and heart rate from 83 to 115 bpm. Non-ischaemic and ischaemic segments showed significant differences in MBF for stenosis grades of FFR ≤ 0.70. At this degree of obstruction, median MBF was 79 (interquartile range [IQR]: 66-90) for non-ischaemic segments versus 56 mL/100 mL/min (IQR: 46-73) for ischaemic segments (p < 0.05). For MBV, a significant difference was found at FFR ≤ 0.80 with median MBV values of 7.6 (IQR: 7.0-8.3) and 7.1 mL/100 mL (IQR: 6.0-8.2) for non-ischaemic and ischaemic myocardial segments, respectively (p < 0.05). CONCLUSION Artificial flow alterations in a Langendorff porcine heart model could be detected and measured by CTP-derived myocardial perfusion parameters and showed significant systematic correlation with stepwise flow reduction that permitted early detection of ischaemic myocardium. Additional research in clinical setting is required to develop absolute quantitative CTP.
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Affiliation(s)
- Gert Jan Pelgrim
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Taylor M Duguay
- Medical University of South Carolina, Department of Radiology, 25 Courtenay Drive, 29425 SC, Charleston, SC, USA
| | - J Marco A Stijnen
- LifeTec Group BV, Kennedyplein 10-11, 5611 ZS, Eindhoven, The Netherlands
| | - Akos Varga-Szemes
- Medical University of South Carolina, Department of Radiology, 25 Courtenay Drive, 29425 SC, Charleston, SC, USA
| | - Sjoerd Van Tuijl
- LifeTec Group BV, Kennedyplein 10-11, 5611 ZS, Eindhoven, The Netherlands
| | - U Joseph Schoepf
- Medical University of South Carolina, Department of Radiology, 25 Courtenay Drive, 29425 SC, Charleston, SC, USA
| | - Matthijs Oudkerk
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Rozemarijn Vliegenthart
- University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Radiology, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Thaiss WM, Sauter AW, Bongers M, Horger M, Nikolaou K. Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology. Eur J Radiol 2015; 84:2368-79. [DOI: 10.1016/j.ejrad.2015.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/02/2015] [Indexed: 12/12/2022]
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