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Fusion Image of Coronary Artery and Myocardial Perfusion Using Computed Tomography
Fusion Image of Coronary Artery and Myocardial Perfusion Using Computed Tomography Teruhito Kido, MD, Akira Kuata, MD, Teruyoshi Uetani, MD, Yuki Tanabe, MD, Hikaru Nishiyama, MS, Akiyoshi Ogimoto, MD, Hironori Izutani, MD, and Teruhito Mochizuki, MD Departments of Radiology, Cardiology, and Cardiothoracic Surgery, Ehime University, Ehime, Japan
FEATURE ARTICLES
Fig 1.
C
oronary angiography of 64-year-old man with chest pain shows the total occlusion (Fig 1, arrows) in the proximal portion of the left ascending coronary artery (LAD). Stress perfusion cardiac magnetic resonance image (MRI) depicts endocardium hypoperfusion area in the LAD territory and late gadolinium enhancement MRI showed subendocardial infarction. In this case, fusion image of coronary computed tomography (CT) and perfusion CT can present coronary lesions and following myocardial ischemia precisely. Precoronary artery bypass grafting (CABG) epicardial image shows the hypoperfusion area in LAD territory (Fig 2A, arrows), and subendocardial image shows the severe hypoperfusion lesion (Fig 2B, arrows). Transmural ischemic changes that were mainly seen in the anteroseptal wall were improved in the epicardium (Fig 2C)
Address correspondence to Dr Kido, Department of Radiology, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan; e-mail: t.k.ehime@ gmail.com.
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
Fig 2.
after CABG. However, subendocardial image shows residual ischemia in the subendocardium (Fig 2D, arrows), which suggests that blood flow could not be improved sufficiently with subendocardial infarction. Combined technique with perfusion CT using a 256-slice multidetector CT and a time axis interpolation technique [1] allowed us to assess CT attenuation independent stratified myocardial ischemia.
Reference 1. Wai B, Thai WE, Brown H, Truong QA. Novel phase-based noise reduction strategy for quantification of left ventricular function and mass assessment by cardiac CT: comparison with cardiac magnetic resonance. Eur J Radiol 2013;82: e337–41.
Ann Thorac Surg 2015;99:715 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.09.065
FEATURE ARTICLES
Fig 1.
C
oronary angiography of 64-year-old man with chest pain shows the total occlusion (Fig 1, arrows) in the proximal portion of the left ascending coronary artery (LAD). Stress perfusion cardiac magnetic resonance image (MRI) depicts endocardium hypoperfusion area in the LAD territory and late gadolinium enhancement MRI showed subendocardial infarction. In this case, fusion image of coronary computed tomography (CT) and perfusion CT can present coronary lesions and following myocardial ischemia precisely. Precoronary artery bypass grafting (CABG) epicardial image shows the hypoperfusion area in LAD territory (Fig 2A, arrows), and subendocardial image shows the severe hypoperfusion lesion (Fig 2B, arrows). Transmural ischemic changes that were mainly seen in the anteroseptal wall were improved in the epicardium (Fig 2C)
Address correspondence to Dr Kido, Department of Radiology, Ehime University, Shitsukawa, Toon, Ehime 791-0295, Japan; e-mail: t.k.ehime@ gmail.com.
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
Fig 2.
after CABG. However, subendocardial image shows residual ischemia in the subendocardium (Fig 2D, arrows), which suggests that blood flow could not be improved sufficiently with subendocardial infarction. Combined technique with perfusion CT using a 256-slice multidetector CT and a time axis interpolation technique [1] allowed us to assess CT attenuation independent stratified myocardial ischemia.
Reference 1. Wai B, Thai WE, Brown H, Truong QA. Novel phase-based noise reduction strategy for quantification of left ventricular function and mass assessment by cardiac CT: comparison with cardiac magnetic resonance. Eur J Radiol 2013;82: e337–41.
Ann Thorac Surg 2015;99:715 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.09.065