Comprehensive cardiac assessment:

coronaries and myocardial perfusion

Clinical Case

Patient History

A woman in her 70s with multiple risk factors and complaining of atypical chest pain was referred to CT for coronary assessment.
Gated dynamic acquisition was performed to assess coronary arteries and myocardial perfusion in a single exam, with a single injection.

Acquisition

  • Prospectively gated dynamic acquisition

  • 160 mm axial for whole organ coverage 

  • 60 cc of contrast media (350 mg I/mL)

  • BMI: 27

  • ASiR-V1 50%

  • DLP 699 mGy-cm

  • 9.7 mSv2

  • Group 1: wash-in (10 passes)

    • 100 kV & 450 mA

    • 0.28 sec rotation speed

    • 2.2 sec between passes 

    Group 2: wash-out (5 passes)

    • 100 kV & 240 mA

    • 0.28 sec rotation speed

    • 4 sec between passes

Results


Coronary arteries are normal, and no significant ischemia was detected on the myocardial perfusion maps.


Conclusion

Dynamic cardiac perfusion was performed with no table motion, taking advantage of the 160 mm-coverage detector that provides uniform image quality and accurate perfusion quantification. With Revolution CT it is now possible to combine anatomical assessment of the coronary tree with an accurate functional assessment of the myocardial perfusion in a single acquisition, using a single injection, at low radiation dose.

This acquisition technique could potentially enable an increase in specificity and positive predictive value of Coronary CT angiography.


Testimonial

« Revolution CT allows acquiring anatomical and functional information in one examination, at low dose. This capability has the potential to reduce the need for additional investigations. In cardiac, this will help us evaluate the impact of a stenosis on the myocardial perfusion and therefore improve the specificity of Cardiac CT. In oncology, perfusion imaging has the potential to help characterize lesion, and to better evaluate the response under specific treatments, such as anti-angiogenics. In early stroke management, identifying penumbra and necrosis can be critical for treatment decision and patient management.”

Jean-Louis Sablayrolles


Enabling Technologies

  • The Revolution CT allows for whole organ dynamic acquisition with up to 160 mm of coverage, with no table motion. This enables perfusion study of the heart, brain, liver, kidneys and other organ and tissues. It also provides you with 4D imaging capabilities for all anatomies to visualize vascular flow, organ motion or kinetic properties.

  • Revolution CT introduces the groundbreaking Gemstone* Clarity Detector, with focally-aligned, miniaturized modules and 3D collimator that is designed to ensure contrast uniformity and excellent image quality across the whole detector and overcome challenges such as cone beam or beam hardening artifacts associated with wide coverage.

  • The next generation of iterative reconstruction, ASiR-V, the flexible collimation (between 5 mm to 160 mm), the variable sampling rate and tube current during dynamic perfusion acquisition help you to optimize radiation dose of such studies. 


>>> Next Clinical Cases:




Related

Footnote

Downloads