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Quantification of Myocardial Blood Flow by Adenosine-stress CT Perfusion Imaging in Pigs During Various Degrees of Stenosis Correlates Well with Coronary Artery Blood Flow and Fractional Flow Reserve


The aim of this study was to determine whether adenosine stress myocardial perfusion imaging by Dual Source CT (CT) enables non-invasive quantification of regional absolute myocardial blood flow (MBF) in an animal model with various degrees of coronary flow reduction.
Cardiac Computed Tomography


Only few preliminary experimental studies demonstrated the feasibility of adenosine stress CT myocardial perfusion
imaging to calculate the absolute MBF, thereby providing information whether a coronary stenosis is flow limiting.


In seven pigs, a coronary flow probe and an adjustable hydraulic occluder were placed around the left anterior descending coronary artery to monitor the distal coronary artery blood flow (CBF) while several degrees of coronary
flow reduction were induced. CT perfusion (CT-MBF) was acquired during adenosine stress with no CBF reduction,
an intermediate (15–39%) and a severe (40–95%) CBF reduction. Reference standards were CBF and fractional flow
reserve measurements (FFR). FFR was simultaneously derived from distal coronary artery pressure and aortic pressure measurements.


CT-MBF decreased progressively with increasing CBF reduction severity from 2.68 (2.31–2.81) mL/g/min (normal CBF) to 1.96 (1.83–2.33) mL/g/min (intermediate CBF-reduction) and to 1.55 (1.14–2.06) mL/g/min (severe CBF-reduction) (both P <0.001). We observed very good correlations between CT-MBF and CBF (r=0.85, P<0.001) and CT-MBF and FFR (r=0.85, P<0.001).


Adenosine stress CT myocardial perfusion imaging allows quantification of regional MBF under various degrees of CBF reduction.

Notes to editor

Presented by Dr Francesca Pugliese
The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.

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