CT Myocardial Perfusion Imaging: A New Frontier in Cardiac Imaging

Figure 2

Static retrospectively ECG gated dual-energy myocardial perfusion imaging. 56-year-old man with multiple cardiovascular risk factors and stable angina. (a) Coronary CT angiography curved multiplanar reconstruction of the left anterior descending artery (LAD) with the corresponding perpendicular views showed a critical stenosis (>70% luminal narrowing) at the proximal segment (arrows) sustained by a large concentric predominately noncalcified plaque with positive remodeling (Remodeling Index= 2.1). (b) The corresponding three-dimensional volume-rendering reconstruction demonstrating the critical stenosis of the proximal LAD (arrow). (c-d) Myocardial short-axis (c) and 2-chamber long-axis (d) color-coded iodine distribution maps of dual-energy CTP imaging during stress showed perfusion defects at the antero-septal, anterior, and antero-lateral wall corresponding to the territory of the left anterior descending artery (arrowheads). Quantitative analysis of the dual-energy map at the level of the anterior wall shows a 71.6% reduction in iodine content (Iodine Density: −0.7 mg/ml) with respect to the remote myocardium at the inferior wall.