CT myocardial perfusion imaging features in chronic total occlusion patients and its evaluation of coronary collateral circulation and viable myocardium
10.3969/j.issn.1005-202X.2025.08.013
- VernacularTitle:慢性完全性闭塞病变CT心肌灌注成像特征及其对冠状动脉侧支循环及存活心肌的评估
- Author:
Xiaojuan LI
1
;
Shuo LIU
1
;
Yan WANG
1
Author Information
1. 新疆维吾尔自治区人民医院放射影像中心,新疆 乌鲁木齐 830000
- Publication Type:Journal Article
- Keywords:
chronic total occlusion;
computed tomography;
myocardial perfusion imaging;
collateral circulation;
viable myocardium
- From:
Chinese Journal of Medical Physics
2025;42(8):1063-1067
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the characteristics of CT myocardial perfusion imaging in chronic total occlusion(CTO)patients and explore its role in assessing coronary collateral circulation and viable myocardium.Methods A cohort of 50 CTO patients were enrolled and underwent both CT myocardial perfusion imaging and coronary angiography.Age,body mass index,gender,chronic comorbidities,coronary artery dominance and CT myocardial perfusion imaging parameters were compared across different patient groups:normal myocardial perfusion,matched myocardial perfusion(reduced resting and stress perfusion),mismatched myocardial perfusion(normal resting but reduced stress perfusion),and Rentrop grade-stratified subgroups(grade 0,1,2 and 3).Results No significant differences in age and body mass index were observed among normal myocardial perfusion group,matched myocardial perfusion group(P>0.05).However,gender distribution,chronic comorbidities and coronary artery dominance differed significantly between groups(P<0.05).Myocardial perfusion reduction on CT was predominantly observed in males,particularly those complicated by chronic diseases and right coronary artery dominance.There was no statistical significance in age and body mass index among patients stratified by Rentrop grade(0,1,2 and 3)(P>0.05),while significant differences emerged in gender distribution,chronic comorbidities and coronary artery dominance(P<0.05).The opening of collateral circulation predominantly occurred in males,particularly those with chronic comorbidities and right coronary artery dominance.Significant differences were found in myocardial blood flow(MBF),myocardial blood volume(MBV),mean transit time(MTT)and time to peak(TTP)among normal myocardial perfusion group,matched myocardial perfusion group and mismatched myocardial perfusion group(P<0.05).The differences in MBF,MBV,TTP and MTT among patients stratified by Rentrop grade(0,1,2,and 3)were significant(P<0.05).Conclusion Significant differences exist in CT myocardial perfusion imaging parameters among CTO patients with varying degrees of coronary collateral circulation and myocardial viability.These parameters may serve as important clinical evaluation indicators.
