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Clinical significance of a single multi-slice CT assessment in patients with coronary chronic total occlusion lesions prior to revascularization.

Qu X, Fang W, Gong K, Ye J, Guan S, Li R, Xu Y, Shen Y, Zhang M, Liu H, Xie W - PLoS ONE (2014)

Bottom Line: Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging.The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging.The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

ABSTRACT
Accurate assessment of coronary chronic total occlusion (CTO) lesion is essential to design an appropriate procedural strategy before revascularization. The present study aims to evaluate the significance of a single multislice computed tomography (MSCT) examination in patients with CTO lesion. We retrospectively analyzed the clinical data of 23 CTO lesions in twenty patients underwent computed tomography coronary angiography (CTCA) and SPECT. The CTCA was more powerful and sensitive to determine the CTO lesion length (100% v.s 47.8%) and to identify the length and location of calcification in occluded vessels compared with the coronary angiography (CAG). The LVEF measured by MSCT was comparable to that from the gated SPECT. Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging. The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging. The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects.

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Bland-Altman Plots of Left Ventricular Ejection Fraction using Multislice Computed Tomography (MSCT) and Single-photon Emission Computed Tomography (SPECT).
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pone-0098242-g002: Bland-Altman Plots of Left Ventricular Ejection Fraction using Multislice Computed Tomography (MSCT) and Single-photon Emission Computed Tomography (SPECT).

Mentions: The assessment of global LV function has important diagnostic and prognostic values in patients with CAD, especially for CTO. The average LVEF (58%±11%) obtained by gated SPECT was comparable to that measured with MSCT (57%±15%). The measurement of LVEF by using MSCT and SPECT methods are highly correlated with a r Pearson coefficient value of 0.79 (P<0.01). Bland-Altman plot analysis indicated a good agreement between the two methods (Fig. 2).


Clinical significance of a single multi-slice CT assessment in patients with coronary chronic total occlusion lesions prior to revascularization.

Qu X, Fang W, Gong K, Ye J, Guan S, Li R, Xu Y, Shen Y, Zhang M, Liu H, Xie W - PLoS ONE (2014)

Bland-Altman Plots of Left Ventricular Ejection Fraction using Multislice Computed Tomography (MSCT) and Single-photon Emission Computed Tomography (SPECT).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048204&req=5

pone-0098242-g002: Bland-Altman Plots of Left Ventricular Ejection Fraction using Multislice Computed Tomography (MSCT) and Single-photon Emission Computed Tomography (SPECT).
Mentions: The assessment of global LV function has important diagnostic and prognostic values in patients with CAD, especially for CTO. The average LVEF (58%±11%) obtained by gated SPECT was comparable to that measured with MSCT (57%±15%). The measurement of LVEF by using MSCT and SPECT methods are highly correlated with a r Pearson coefficient value of 0.79 (P<0.01). Bland-Altman plot analysis indicated a good agreement between the two methods (Fig. 2).

Bottom Line: Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging.The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging.The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

ABSTRACT
Accurate assessment of coronary chronic total occlusion (CTO) lesion is essential to design an appropriate procedural strategy before revascularization. The present study aims to evaluate the significance of a single multislice computed tomography (MSCT) examination in patients with CTO lesion. We retrospectively analyzed the clinical data of 23 CTO lesions in twenty patients underwent computed tomography coronary angiography (CTCA) and SPECT. The CTCA was more powerful and sensitive to determine the CTO lesion length (100% v.s 47.8%) and to identify the length and location of calcification in occluded vessels compared with the coronary angiography (CAG). The LVEF measured by MSCT was comparable to that from the gated SPECT. Myocardial perfusion imaging showed that the location of the early defect region identified by MSCT was corresponded to the nuclide filling defect on the stressed 201thallium-SPECT imaging. The late hyperenhancement on MSCT was presented as incomplete nuclide filling on the 99mTc-MIBI imaging. The results suggested that a single MSCT examination in previous myocardial infarction without revascularization facilitates to provide some valuable information on the nature of the occluded lesion, myocardial perfusion and globe cardiac function, which would be helpful to design appropriate revascularization strategy in these subjects.

Show MeSH
Related in: MedlinePlus