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Comparative Analysis between SPECT Myocardial Perfusion Imaging and CT Coronary Angiography for Diagnosis of Coronary Artery Disease.

Li JM, Li T, Shi RF, Zhang LR - Int J Mol Imaging (2012)

Bottom Line: Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively.And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD.They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Tianjin Medical University, Cardiovascular Clinical Institute and TEDA International Cardiovascular Hospital, Tianjin 300457, China.

ABSTRACT
The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

No MeSH data available.


Related in: MedlinePlus

Patient with stenosis in the proximal segment of LAD classified as ≥50% on CTCA related with large and reversible perfusion defects (ischemia) in apex, anterior, and septal wall on MPI. (a) and (b) Multiple reformation (MPR) and maximal intensity projection (MIP) on CTCA showed noncalcification plaque in the proximal segment of LAD adjacent to the ostia of diagonal branch causing a significant stenosis (arrows), and no positive results on other main arteries were found. (c) ICA of left coronary arteries showed severe stenosis (arrow) in the same segment of LAD compared with CTCA. (d) ICA of left coronary arteries showed successful stenting (arrow) for the lesion in the proximal segment of LAD. (e) SPECT MPI study at stress (odd row) and rest (even row) showed large and reversible perfusion defects in the area of apex, anterior and septal wall corresponding to the territory of LAD, indicating large and severe myocardial ischemia.
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fig3: Patient with stenosis in the proximal segment of LAD classified as ≥50% on CTCA related with large and reversible perfusion defects (ischemia) in apex, anterior, and septal wall on MPI. (a) and (b) Multiple reformation (MPR) and maximal intensity projection (MIP) on CTCA showed noncalcification plaque in the proximal segment of LAD adjacent to the ostia of diagonal branch causing a significant stenosis (arrows), and no positive results on other main arteries were found. (c) ICA of left coronary arteries showed severe stenosis (arrow) in the same segment of LAD compared with CTCA. (d) ICA of left coronary arteries showed successful stenting (arrow) for the lesion in the proximal segment of LAD. (e) SPECT MPI study at stress (odd row) and rest (even row) showed large and reversible perfusion defects in the area of apex, anterior and septal wall corresponding to the territory of LAD, indicating large and severe myocardial ischemia.

Mentions: It was important to note that one patient with balanced three-vessel stenoses (narrowing of 80% for LAD, LCX, and RCA) was missed by MPI among seven negative patients who underwent SPECT compared with ICA. Figure 3 presents a typical case of a 55-year-old man with intermittent angina pectoris for half a year. Anatomic and physiologic information provided by CTCA and MPI showed that interventional therapy should be directed to the lesion in the proximal segment of LAD. The patient finally received stent implantation for the lesion located in the LAD with success. A typical case is shown in Figure 3.


Comparative Analysis between SPECT Myocardial Perfusion Imaging and CT Coronary Angiography for Diagnosis of Coronary Artery Disease.

Li JM, Li T, Shi RF, Zhang LR - Int J Mol Imaging (2012)

Patient with stenosis in the proximal segment of LAD classified as ≥50% on CTCA related with large and reversible perfusion defects (ischemia) in apex, anterior, and septal wall on MPI. (a) and (b) Multiple reformation (MPR) and maximal intensity projection (MIP) on CTCA showed noncalcification plaque in the proximal segment of LAD adjacent to the ostia of diagonal branch causing a significant stenosis (arrows), and no positive results on other main arteries were found. (c) ICA of left coronary arteries showed severe stenosis (arrow) in the same segment of LAD compared with CTCA. (d) ICA of left coronary arteries showed successful stenting (arrow) for the lesion in the proximal segment of LAD. (e) SPECT MPI study at stress (odd row) and rest (even row) showed large and reversible perfusion defects in the area of apex, anterior and septal wall corresponding to the territory of LAD, indicating large and severe myocardial ischemia.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig3: Patient with stenosis in the proximal segment of LAD classified as ≥50% on CTCA related with large and reversible perfusion defects (ischemia) in apex, anterior, and septal wall on MPI. (a) and (b) Multiple reformation (MPR) and maximal intensity projection (MIP) on CTCA showed noncalcification plaque in the proximal segment of LAD adjacent to the ostia of diagonal branch causing a significant stenosis (arrows), and no positive results on other main arteries were found. (c) ICA of left coronary arteries showed severe stenosis (arrow) in the same segment of LAD compared with CTCA. (d) ICA of left coronary arteries showed successful stenting (arrow) for the lesion in the proximal segment of LAD. (e) SPECT MPI study at stress (odd row) and rest (even row) showed large and reversible perfusion defects in the area of apex, anterior and septal wall corresponding to the territory of LAD, indicating large and severe myocardial ischemia.
Mentions: It was important to note that one patient with balanced three-vessel stenoses (narrowing of 80% for LAD, LCX, and RCA) was missed by MPI among seven negative patients who underwent SPECT compared with ICA. Figure 3 presents a typical case of a 55-year-old man with intermittent angina pectoris for half a year. Anatomic and physiologic information provided by CTCA and MPI showed that interventional therapy should be directed to the lesion in the proximal segment of LAD. The patient finally received stent implantation for the lesion located in the LAD with success. A typical case is shown in Figure 3.

Bottom Line: Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively.And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD.They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Tianjin Medical University, Cardiovascular Clinical Institute and TEDA International Cardiovascular Hospital, Tianjin 300457, China.

ABSTRACT
The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.

No MeSH data available.


Related in: MedlinePlus