Diagnostic value of blood flow reserve measurement with 13N-NH3·H2O PET/CT imaging in patients with coronary microvascular disease / 中华核医学与分子影像杂志

ABSTRACT

Objective@#To evaluate the diagnostic value of coronary flow reserve (CFR) on 13N-NH3·H2O PET/CT imaging for patients with suspected coronary microvascular disease (CMVD).@*Methods@#From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 females; age 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coronary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data.@*Results@#Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0.63±0.09) ml·g-1·min-1) and stress LV-MBF was lower ((1.52±0.36) vs (1.89±0.22) ml·g-1·min-1; t values 2.925, -4.503, both P<0.05). There was no significant difference between the two groups in other semi-quantitative parameters (t values from -1.430 to 1.400, U values 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values 0.798-0.836, all P<0.01).@*Conclusion@#CFR measured with PET/CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without obvious epicardial coronary artery stenosis and suspected with CMVD.