Diagnostic value of blood flow reserve measurement with 13N-NH3·H2O PET/CT imaging in patients with coronary microvascular disease
10.3760/cma.j.issn.2095-2848.2019.12.002
- VernacularTitle: 13N-NH3·H2O PET/CT显像血流储备测定对冠状动脉微血管疾病的诊断价值
- Author:
Kun PENG
1
;
Weiqiang CHEN
2
;
Yongde WANG
2
;
Jian ZHANG
2
;
Jianming LI
1
Author Information
1. Department of Nuclear Medicine, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
2. Department of Cardiology, TEDA International Cardiovascular Hospital and Tianjin Medical University Cardiovascular Clinical Institute, Tianjin 300457, China
- Publication Type:Journal Article
- Keywords:
Coronary artery disease;
Microvascular angina;
Fractional flow reserve, myocardial;
Myocardial perfusion imaging;
Positron-emission tomography;
Tomography, X-ray computed;
Ammonia
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2019;39(12):708-713
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the diagnostic value of coronary flow reserve (CFR) on 13N-NH3·H2O PET/CT imaging for patients with suspected coronary microvascular disease (CMVD).
Methods:From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 females; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coronary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data.
Results:Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0.63±0.09) ml·g-1·min-1) and stress LV-MBF was lower ((1.52±0.36) vs (1.89±0.22) ml·g-1·min-1; t values: 2.925, -4.503, both P<0.05). There was no significant difference between the two groups in other semi-quantitative parameters (t values: from -1.430 to 1.400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01).
Conclusion:CFR measured with PET/CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without obvious epicardial coronary artery stenosis and suspected with CMVD.
