Full Text:   <1457>

CLC number: R543.3

On-line Access: 2011-06-07

Received: 2010-09-20

Revision Accepted: 2011-01-20

Crosschecked: 2011-05-11

Cited: 1

Clicked: 3548

Citations:  Bibtex RefMan EndNote GB/T7714

-   Go to

Article info.
1. Reference List
Open peer comments

Journal of Zhejiang University SCIENCE B 2011 Vol.12 No.6 P.485-491


A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest

Author(s):  Qi Wang, Jing Qin, Lu-yue Gai, Yun-dai Chen, Wei Dong, Zhi-wei Guan, Zhi-guo Wang, Zhi-jun Sun, Jia-he Tian

Affiliation(s):  Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China, Department of Ultrasound, Chinese Armed Police General Hospital, Beijing 100039, China, Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing 100853, China

Corresponding email(s):   luyuegai301@yahoo.com.cn

Key Words:  Coronary artery disease, Myocardial ischemia, Perfusion, Multislice computed tomography

Qi Wang, Jing Qin, Lu-yue Gai, Yun-dai Chen, Wei Dong, Zhi-wei Guan, Zhi-guo Wang, Zhi-jun Sun, Jia-he Tian. A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest[J]. Journal of Zhejiang University Science B, 2011, 12(6): 485-491.

@article{title="A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest",
author="Qi Wang, Jing Qin, Lu-yue Gai, Yun-dai Chen, Wei Dong, Zhi-wei Guan, Zhi-guo Wang, Zhi-jun Sun, Jia-he Tian",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest
%A Qi Wang
%A Jing Qin
%A Lu-yue Gai
%A Yun-dai Chen
%A Wei Dong
%A Zhi-wei Guan
%A Zhi-guo Wang
%A Zhi-jun Sun
%A Jia-he Tian
%J Journal of Zhejiang University SCIENCE B
%V 12
%N 6
%P 485-491
%@ 1673-1581
%D 2011
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1000342

T1 - A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest
A1 - Qi Wang
A1 - Jing Qin
A1 - Lu-yue Gai
A1 - Yun-dai Chen
A1 - Wei Dong
A1 - Zhi-wei Guan
A1 - Zhi-guo Wang
A1 - Zhi-jun Sun
A1 - Jia-he Tian
J0 - Journal of Zhejiang University Science B
VL - 12
IS - 6
SP - 485
EP - 491
%@ 1673-1581
Y1 - 2011
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1000342

Background: Although computed tomography coronary angiography (CTCA) can identify coronary stenosis, little data exists on the ability of multislice computed tomography (MSCT) to detect myocardial perfusion defects at rest. Methods: In 33 patients with diagnosed or suspected coronary artery disease (CAD), CTCA using retrospective electrocardiography (ECG) gating at rest and invasive coronary angiography (ICA) was performed. The 2D myocardial images were reconstructed in diastolic and systolic phases using the same raw data for CTCA. CT values of the myocardium were used as an estimate of myocardial enhancement, which were shown by color mapping. myocardial ischemia was defined as a pattern of transient endocardial hypo-enhancement at systole and normal enhancement at diastole. The results of ICA were taken as the reference standard. Results: When a diameter reduction of more than 50% in ICA was used as diagnostic criteria of CAD, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT first-pass myocardial perfusion imaging (MPI) at rest were 0.85, 0.67, 0.92, and 0.50 per patient, respectively, and 0.58, 0.93, 0.85, and 0.76 per vessel, respectively. Conclusions: CT first-pass MPI at rest could detect CAD patients, which could become a practical and convenient way to detect ischemia, consequently offering the ability for MSCT to act as a “one stop shop” for the diagnosis of CAD.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1]Austen, W.G., Edwards, J.E., Frye, R.L., Gensini, G.G., Gott, V.L., Griffith, L.S., McGoon, D.C., Murphy, M.L., Roe, B.B., 1975. A reporting system on patients evaluated for coronary artery disease: report of the Ad-Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery. Circulation, 51(4 Suppl.):5-40.

[2]Blankstein, R., Shturman, L.D., Rogers, I.S., Rocha-Filho, J.A., Okada, D.R., Sarwar, A., Soni, A.V., Bezerra, H., Ghoshhajra, B.B., Petranovic, M., et al., 2009. Adenosine-induced stress myocardial perfusion imaging using dual-source cardiac computed tomography. J. Am. Coll. Cardiol., 54(12):1072-1084.

[3]Cerqueira, M.D., Weissman, N.J., Dilsizian, V., Jacobs, A.K., Kaul, S., Laskey, W.K., Pennell, D.J., Rumberger, J.A., Ryan, T., Verani, M.S., 2002. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Int. J. Cardiovasc. Imaging, 18(1):539-542.

[4]Chilian, W.M., 1991. Microvascular pressures and resistances in the left ventricular subepicardium and subendocardium. Circ. Res., 69(3):561-570.

[5]Ferencik, M., Nomura, C.H., Maurovich-Horvat, P., Hoffmann, U., Pena, A.J., Cury, R.C., Abbara, S., Nieman, K., Fatima, U., Achenbach, S., et al., 2006. Quantitative parameters of image quality in 64-slice computed tomography angiography of the coronary arteries. Eur. J. Radiol., 57(3):373-379.

[6]George, R.T., Silva, C., Cordeiro, M.A., DiPaula, A., Thompson, D.R., McCarthy, W.F., Ichihara, T., Lima, J.A., Lardo, A.C., 2006. Multidetector computed tomography myocardial perfusion imaging during adenosine stress. J. Am. Coll. Cardiol., 48(1):153-160.

[7]George, R.T., Jerosch-Herold, M., Silva, C., Kitagawa, K., Bluemke, D.A., Lima, J.A., Lardo, A.C., 2007. Quantification of myocardial perfusion using dynamic 64-detector computed tomography. Invest. Radiol., 42(12):815-822.

[8]Goto, M., Flynn, A.E., Doucette, J.W., Jansen, C.M., Stork, M.M., Coggins, D.L., Muehrcke, D.D., Husseini, W.K., Hoffman, J.I., 1991. Cardiac contraction affects deep myocardial vessels predominantly. Am. J. Physiol., 261(5 Pt 2):1417-1429.

[9]Henneman, M.M., Schuijf, J.D., van Werkhoven, J.M., Pundziute, G., van der Wall, E.E., Jukema, J.W., Bax, J.J., 2008. Multi-slice computed tomography coronary angiography for ruling out suspected coronary artery disease: what is the prevalence of a normal study in a general clinical population? Eur. Heart J., 29(16):2006-2013.

[10]Iwanaga, S., Ewing, S.G., Husseini, W.K., Hoffman, J.I., 1995. Changes in contractility and afterload have only slight effects on subendocardial flow impediment. Am. J. Physiol., 269(4):1202-1212.

[11]Kido, T., Kurata, A., Higashino, H., Inoue, Y., Kanza, R.E., Okayama, H., Higaki, J., Murase, K., Mochizuki, T., 2008. Quantification of regional myocardial blood flow using first-pass multidetector-row computed tomography and adenosine triphosphate in coronary artery disease. Circ. J., 72(7):1086-1091.

[12]Kurata, A., Mochizuki, T., Koyama, Y., Haraikawa, T., Suzuki, J., Shigematsu, Y., Higaki, J., 2005. Myocardial perfusion imaging using adenosine triphosphate stress multi-slice spiral computed tomography: alternative to stress myocardial perfusion scintigraphy. Circ. J., 69(5):550-557.

[13]Li, P., Gai, L.Y., Yang, X., Sun, Z.J., Jin, Q.H., 2010. Computed tomography angiography-guided percutaneous coronary intervention in chronic total occlusion. J. Zhejiang Univ.-Sci. B (Biomed. & Biotechnol.), 11(8):568-574.

[14]Meijboom, W.B., van Mieghem, C.A., van Pelt, N., Weustink, A., Pugliese, F., Mollet, N.R., Boersma, E., Regar, E., van Geuns, R.J., et al., 2008. Comprehensive assessment of coronary artery stenoses: computed tomography coronary angiography versus conventional coronary angiography and correlation with fractional flow reserve in patients with stable angina. J. Am. Coll. Cardiol., 52(8):636-643.

[15]Mollet, N.R., Cademartiri, F., van Mieghem, C.A., Runza, G., McFadden, E.P., Baks, T., Serruys, P.W., Krestin, G.P., de Feyter, P.J., 2005. High-resolution spiral computed tomography coronary angiography in patients referred for diagnosic conventional coronary angiography. Circulation, 112(15):2318-2323.

[16]Nagao, M., Matsuoka, H., Kawakami, H., Higashino, H., Mochizuki, T., Murase, K., Uemura, M., 2008. Quantification of myocardial perfusion by contrast-enhanced 64-MDCT: characterization of ischemic myocardium. Am. J. Roentgenol., 191(1):19-25.

[17]Nagao, M., Matsuoka, H., Kawakami, H., Higashino, H., Mochizuki, T., Ohshita, A., Kohno, T., Shigemi, S., 2009. Detection of myocardial ischemia using 64-slice MDCT. Circ. J., 73(5):905-911.

[18]Pugliese, F., Mollet, N.R., Runza, G., van Mieghem, C., Meijboom, W.B., Malagutti, P., Baks, T., Krestin, G.P., deFeyter, P.J., Cademartiri, F., 2006. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur. Radiol., 16(3):575-582.

[19]Raff, G.L., Gallagher, M.J., O′Neill, W.W., Goldstein, J.A., 2005. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J. Am. Coll. Cardiol., 46(3):552-557.

[20]Sabbah, H.M., Stein, P.D., 1982. Effect of acute regional ischemia on pressure in the subepicardium and subendocardium. Am. J. Physiol., 242(2):240-244.

[21]Shaw, L.J., Hachamovitch, R., Berman, D.S., Marwick, T.H., Lauer, M.S., Heller, G.V., Iskandrian, A.E., Kesler, K.L., Travin, M.I., Lewin, H.C., et al., 1999. The economic consequences of available diagnostic and prognostic strategies for the evaluation of stable angina patients: an observational assessment of the value of precatheterization ischemia. J. Am. Coll. Cardiol., 33(3):661-669.

[22]Toyota, E., Fujimoto, K., Ogasawara, Y., Kajita, T., Shigeto, F., Matsumoto, T., Goto, M., Kajiya, F., 2002. Dynamic changes in three-dimensional architecture and vascular volume of transmural coronary microvasculature between diastolic- and systolic-arrested rat hearts. Circulation, 105(5):621-626.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - Journal of Zhejiang University-SCIENCE