OBJECTIVE: To test the feasibility of regadenoson stress dynamic perfusion computed tomography (DPCT) in CLTI patients.
METHODS: Between 2018 and 2023, coronary computed tomography angiography (CTA) and, in the case of a calcium score higher than 400, DPCT, were performed in 25 CLTI patients with a history of endovascular revascularization.
RESULTS: Of the 25 patients, 19 had a calcium score higher than 400, requiring DPCT image acquisition. Obstructive CAD could be ruled out in 10 of the 25 patients. Of the 15 CTA/DPCT+ patients, 13 proceeded to coronary angiography (CAG). Revascularization was necessary in all 13 patients. In these 13 patients, vessel-based sensitivity and specificity of coronary CTA/DPCT as compared to invasive evaluation was 75%, respectively. At follow-up (27 ± 21 months) there was no statistically significant difference in all-cause mortality between CTA/DPCT- positive and -negative patients (p = 0.065).
CONCLUSIONS: Despite a high prevalence of severe CAC, coronary CTA complemented by DPCT may be a feasible method to detect obstructive and functionally significant CAD in CLTI patients.
目的:验证在CLTI患者中应用regadenoson应力动态灌注CT(DPCT)的可行性。
方法:在2018年至2023年之间,冠状动脉计算机断层扫描血管造影(CTA)和,在钙评分高于400的情况下,DPCT,在25例有血管内血运重建史的CLTI患者中进行。
结果:在25名患者中,19具有高于400的钙评分,需要DPCT图像采集。25例患者中有10例可以排除阻塞性CAD。15例CTA/DPCT+患者中,13进行冠状动脉造影(CAG)。所有13例患者都需要进行血运重建。在这13名患者中,冠状动脉CTA/DPCT的血管敏感性和特异性与侵入性评估相比为75%,分别。在随访(27±21个月)时,CTA/DPCT阳性和阴性患者的全因死亡率无统计学差异(p=0.065)。
结论:尽管严重CAC的患病率很高,DPCT补充冠状动脉CTA可能是检测CLTI患者阻塞性和功能显著CAD的可行方法.