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The study aimed to investigate the feasibility of using EEV derived from myocardial computed tomography (CT) perfusion imaging (VPCT) and extracellular volume quantification with single-energy subtraction CT (ECV<jats:sub>\u2212\u2009SECT<\/jats:sub>) for quantifying myocardial fibrosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this study, 17 patients with suspected and known coronary artery disease underwent examination using a dual-source CT scanner. The EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> was derived from dynamic whole-heart myocardial perfusion imaging, and the ECV<jats:sub>_SECT<\/jats:sub> was calculated from late-enhanced images 5\u00a0min after bolus contrast injection by subtracting the noncontrast baseline. The late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging was used as a reference.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In total, 11 patients and 73 segments exhibited positivity for LGE on CMR imaging. These were classified into three groups according to the segments: fibrotic segments (group I, <jats:italic>n<\/jats:italic>\u2009=\u200973), nonfibrotic segments in LGE-positive patients (group II, <jats:italic>n<\/jats:italic>\u2009=\u2009103), and segments in LGE-negative patients (group III, <jats:italic>n<\/jats:italic>\u2009=\u200980). ECV<jats:sub>\u2212\u2009SECT<\/jats:sub>, EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub>, myocardial blood flow (MBF), and myocardial blood volume (MBV) significantly differed among these groups (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). ECV<jats:sub>\u2212\u2009SECT<\/jats:sub> was significantly higher and EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub>, MBF, and MBV were significantly lower in fibrotic myocardial segments than in nonfibrotic ones (all <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). ECV<jats:sub>\u2212\u2009SECT<\/jats:sub> and EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> independently affected myocardial fibrosis. There was no significant correlation between ECV<jats:sub>\u2212\u2009SECT<\/jats:sub> and EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub>. The capability of EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> to diagnose myocardial fibrosis was equivalent to that of ECV<jats:sub>\u2212\u2009SECT<\/jats:sub> (area under the curve: 0.798 vs. 0.806, <jats:italic>P<\/jats:italic>\u2009=\u20090.844). ECV<jats:sub>\u2212\u2009SECT<\/jats:sub> of &gt;\u200941.2% and EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> of &lt;\u200910.3% indicated myocardial fibrosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> is actually first-pass distribution volume that can feasibly be used to quantify myocardial fibrosis. Furthermore, the diagnostic efficacy of EEV<jats:sub>\u2212\u2009VPCT<\/jats:sub> is comparable to that of ECV<jats:sub>\u2212\u2009SECT<\/jats:sub>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-024-01226-3","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T12:02:29Z","timestamp":1707739349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quantitating myocardial fibrosis using extracellular extravascular volume determined from computed tomography myocardial perfusion imaging"],"prefix":"10.1186","volume":"24","author":[{"given":"Na","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7644-3711","authenticated-orcid":false,"given":"Heshui","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"issue":"5","key":"1226_CR1","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1172\/JCI87491","volume":"127","author":"NG Frangogiannis","year":"2017","unstructured":"Frangogiannis NG. 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