Adenosine triphosphate(ATP)를 이용한 운동부하 cardiac CT angiography 검사의 특성과 유용성

Characteristics and Usability of ATP-Based CT Angiography on Cardiac Exercise Stress

Purpose In the sphere of noninvasive CT (Computed Tomography), the perfusion evaluation of the left ventricle has been recently performed through the technical advance of MDCT (Multi-Detector Computed Tormgraphy) and the application of ECG gating. In this study, cardiac stress CT was performed by using ATP (Adenosine Triphosphate : DENOSIN？？) on purpose to evaluate cardiac diseases through cardiac rest CT and myocardial image analysis, and to analyze the characteristics of cardiac stress CT and its usability. Materials and Methods The 33 patients, who underwent ATP cardiac CT from July 1, 2006 until January 31, 2007 in this hospital, were subject to this study and the medical data of 33 cases, collected from them, were applied to the research. ATP of 0.84mg/kg was slowly administered by using the syringe pump for 6 minutes. A stress view was taken after 5 minutes, and a rest view was taken 15 minutes after ATP was ceased. As regards image analysis, ROI (Region of Interest) was measured at the 4 segments in the ventricle, and PD (Physical Density) analysis and qualitative analysis were performed. Results 1. The average density of myocardial lesion was different, about between 50 and 60mg/cm³, as compared with those of other lesions. 2. The result of rest investigation was compared with the cases where myocardial ischemic lesion is observed in stress among the patients who showed the perfusion defects of myocardium. In result, the sensitivity to cardiovascular diseases was higher in stress investigation as compared with that of rest investigation. 3. Myocardial segments were mieasured by ROI analysis, with the consequence that the mild stenosis of the coronary artery could be diagnosed. Conclusion It is considered that the ATP-based cardiac stress CT is useful to compare evaluate the myocardium in cardiac excitement with stabilization, and to detect the coronary artery stenosis latent in patients. In addition, it is expected to research the characteristics of investigations through ROI analysis and image analysis, and to extend the existing diagnostic range in cardiac examination.