DYNA-CT ) for 3 D Coronary Reconstruction and Myocardial Perfusion Assessment

Background: A three dimensional reconstruction of the coronary tree is nowadays usually performed using multidetector computed tomographic angiography whereas myocardial perfusion deficits are assessed by SPECT, cardiac MRI or MSCT. A combination of a precise reconstruction of the coronary arteries in combination with an information about the perfusion situation in the supplied myocardium might also be desired to facilitate complex coronary interventions. The aim of our study was to prove the feasibility of a new C-arm based three-dimensional reconstruction algorithm of the coronary arteries in combination with myocardial perfusion assessment. Methods: In 20 Patients, referred for PCI, a rotational coronary angiography using a monoplane C-arm sytstem (Artis zee; Siemens, Erlangen, Germany) was performed. During the 5s run 133 projections were acquired along a 198° arc (99° right anterior oblique to 99° left anterior oblique view). A recently developed 3D-reconstruction technique was applied:and an initial reference 3D image at the desired cardiac phase was reconstructed from 20 projection images selected by ECG gating showing the coarse structure of the coronary tree. The intermediate 3D images are registered to the reference 3D image and accumulated yielding a tomographic 3D image. The perfusion asssessment was done during the myocardial phase of the contrast transit. The resulting dataset was reconstructed and analyzed using short axis and long axis maximum intensity projections (MIP) with 5mm slice thickness. After this a fusion of the 3D-reconstruted coronary tree with the perfusion image was performed in 20 patients (mean age71 9 ys., 5 female): In all 20 cases the LCA was contrasted. This was feasible in all patients with a good imaging of the whole coronary tree and the perfusion situation of the myocardium. Results: After this a fusion of the coronary tree with the perfusion image was performed in 20 patients (mean age71 9 ys.). This was feasible in all patients with a good imaging of the whole coronary tree and the perfusion situation of the myocardium. Conclusions: These data suggest, that simultaneous motion corrected C-arm-CT reconstruction of coronary arteries and perfusion imaging is feasible.