Figure 1 (a)
Calcium scor-ing
Adenosine infusion Stress scan Sublingual NTG(Optional)
Rest scan(CTA)
Scan range 4 to 5 minutes (until the end of stress
scan)
Retrospective ECG-gat-ing
2 minutes beforeRest scan
Retrospective ECG-gating
10 to 20 minutes interval
Option1. Static perfusion2. Dynamic perfusion
Option1. Retrospective mode2. Prospective mode3. High-pitch mode
Figure 1 (b)
Calcium scoring Rest scan(CTA)
Adenosine infusion Stress scan
Define scan range Retrospective ECG-gating 4 to 5 minutes (until the end of stress scan)
Retrospective ECG-gating
10 to 20 minutes interval
Option1. Static perfusion2. Dynamic perfusion
Option1. Retrospective mode2. Prospective mode3. High-pitch mode
Figure 2
20 40 60 80
Scan time (s)
150
300
En
han
cem
ent
(HU
)
– Artery
Time Attenuation Curve (TAC)
– Myocardium
Dynamic
Snapshotor helical
Dynamic
Snapshot or helical
Figure 2 (QR)
Figure 3(a)
Figure 3(b)
Figure 4 (a)
Figure 4 (b)
Figure 4 (c)
Figure 5
Step 1 Step 2 Step 3 Step 4 Step 5
Rest scan interpre-tation Image processing Quality assess Image interpretation Correlation with rest
scan
•Coronary artery stenosis and plaque analysis
•Best phases of motionless my-ocardium
•Epi-and endocar-dial contour (for dynamic study)
• Motion artifact• Beam hardening• Cone-beam• Stair-step• Image noise
•Transmurality (≥50% or <50%)• Reversibility• Myocardial thinning• Simultaneous vision of both stress and rest scans
Match perfusion defect and coronary artery le-
sion
Figure 6(a)
Figure 6(b)
Figure 6(c)
Figure 7
Stress Perfusion
Continuous adenosine infusion140ug/kg/min
4-5min
Start adenosine
Contrast bolus injection0.03-0.1mmol/kg
Rest Perfusion
Viability12-15 min interval
Contrast bolus injection0.03-0.1mmol/kg
5 min interval
Stop adenosine
survey Cine, etc
30min
Figure 8 (a)
Figure 8 (b)
Figure 8 (c)
Figure 9 Measurement of Relative Upslope for Myocardial Perfusion Reserve Index (MPRI)
Figure 10 (a)
Figure 10 (b)
Figure 10 (c)
Figure 10 (d) and (e)
Figure 10 (f)
Figure 11 (a)
Figure 11 (b)
Figure 11 (c)
Figure 11 (d)
Figure 11 (e)
Figure 11 (f)
Figure 11 (g)
Figure 11 (h)
Figure 11 (i)
Figure 11 (j)
Figure 11 (k)
Figure 11 (QR-h)
Figure 11 (QR-i)
Figure 11 (QR-j)
Figure 11 (QR-k)
Figure 11 (QR2-a)
LAD LCX
Figure 11 (QR2-b)
Figure 11 (QR2-c)
Figure 11 (QR2-d)
Figure 12(A)
Figure 12(B)
Figure 12(C)
Figure 13(a)
Figure 13(b)
Figure 13 (c)
Figure 13 (d)
Figure 13 (e)
RCA LAD
Figure 14 (a)
Figure 14(b)
Figure 14(c)
Figure 14(d)
Figure 14- QR-1 MR perfusion study, coronary CT angiography is
inconclusive study
QR-2 for figure 14-a
QR-2 for figure 14-b
QR-2 for figure 14-c
QR-2 for figure 14-d
Figure 15 (a)
Figure 15 (b)
Figure 15 (c)
Figure 15 (d)
Figure 16(a)
Figure 16(b)
Figure 17 (a)
Figure 17(b)
Figure 18 (a)
Figure 18 (b)
Figure 19(a)
Figure 19(b)
Figure 19(c)
Figure 19(d)
Figure 20 (a)
Figure 20 (b)