Dual-energy CT angiography plus CT perfusion-diagnostic value in coronary artery disease: initial experience
10.3760/cma.j.issn.1005-1201.2011.02.004
- VernacularTitle:双能量CT冠状动脉成像结合CT心肌灌注诊断冠心病准确性的初步研究
- Author:
Rui WANG
;
Zhaoqi ZHANG
;
Miao GUO
;
Xiaoyong HUANG
;
Wei YU
;
Yongmei WANG
;
Zixu YAN
;
Tao BI
;
Yang YU
;
Liqun CHI
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Myocardium;
Perfusion;
Tomography,X-ray computed
- From:
Chinese Journal of Radiology
2011;45(2):111-115
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the combination of dual-energy CT angiography (DE-CTA) and dual-energy CT peffusion (DE-CTP) in the diagnosis of coronary artery disease. Methods Thirty-one patients with angina pectoris were examined using dual-source dual energy CT and conventional coronary angiography. For DE-CTA, we used a contrast-enhanced ECG-gated coronary scan protocol with energy levels of two tube detector arrays at 140 and 100 kVp. Two kinds of acquired images were fused for the CT angiogram and further calculated to construct a perfusion map (Siemens DE Heart PBV). The compared the following results: DE-CTA vs. CA, DE-CTP vs. CA to assess the sensitivity and specificity, and further compared DE-CTA plus DE-CTP with CA. Results DECT obtained diagnostic image quality in 28 patients.DE-CTA detected 41/112 arterial stenosis. Using CA as a reference, the sensitivity of DE-CTA was 81%(38/47), specificity was 95% (62/65), positive predictive value was 92% (38/41), negative predictive value was 87% (62/71), and accuracy was 89% (100/112). DE-CTP detected 46 perfusion defects in artery territories. Using CA as a reference, the sensitivity of DE-CTP was 76% ( 36/47), specificity was 85% (55/65), positive predictive value was 78% (36/46), negative predictive value was 83% (55/66),and accuracy was 81% (91/112). DE-CTA plus DE-CTP diagnosed 52 arteries stenosis. Using CA as a reference, combination of DE-CTA and DE-CTP gave sensitivity of 95% ( 45/47 ), specificity of 89%(58/65) , NPV of 97% (58/60), and accuracy of 92% (103/112). Conclusions DECT can provide perfusion blood volume information as well as vessel pathology in one scan. DECT can provide comprehensive diagnosis and improve diagnosis of CAD.
