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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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Representative Myocardial Perfusion Images of the Left Anterior Descending Coronary Artery (LAD) and Right Coronary Artery (RCA) using both MSCT and SPECT Examination.3A: MSCT early scanning; 3B: MSCT late scanning; 3C: Stressed thallium-201 (201TI)-SPECT imaging; 3D: 99mTc-MIBI imaging; 3E: 201TI-SPECT late resting image.
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pone-0098242-g003: Representative Myocardial Perfusion Images of the Left Anterior Descending Coronary Artery (LAD) and Right Coronary Artery (RCA) using both MSCT and SPECT Examination.3A: MSCT early scanning; 3B: MSCT late scanning; 3C: Stressed thallium-201 (201TI)-SPECT imaging; 3D: 99mTc-MIBI imaging; 3E: 201TI-SPECT late resting image.

Mentions: In addition, table 2 showed that a total of 10 patients with CTO finished myocardial perfusion imaging using both MSCT and SPECT. The location of the early perfusion defect region identified by MSCT was corresponded to the nuclide filling defect detected by stressed 201TI-SPECT perfusion imaging. In patients with late hyperenhancement in MSCT, 99mTc-MIBI imaging showed incomplete nuclide filling. By contrast, the complete nuclide filling was shown on 99mTc-MIBI imaging in patients without late hyperenhancement on MSCT scan. Figure 3 shows an example of a large perfusion defect on MSCT and SPECT.


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)

Representative Myocardial Perfusion Images of the Left Anterior Descending Coronary Artery (LAD) and Right Coronary Artery (RCA) using both MSCT and SPECT Examination.3A: MSCT early scanning; 3B: MSCT late scanning; 3C: Stressed thallium-201 (201TI)-SPECT imaging; 3D: 99mTc-MIBI imaging; 3E: 201TI-SPECT late resting image.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0098242-g003: Representative Myocardial Perfusion Images of the Left Anterior Descending Coronary Artery (LAD) and Right Coronary Artery (RCA) using both MSCT and SPECT Examination.3A: MSCT early scanning; 3B: MSCT late scanning; 3C: Stressed thallium-201 (201TI)-SPECT imaging; 3D: 99mTc-MIBI imaging; 3E: 201TI-SPECT late resting image.
Mentions: In addition, table 2 showed that a total of 10 patients with CTO finished myocardial perfusion imaging using both MSCT and SPECT. The location of the early perfusion defect region identified by MSCT was corresponded to the nuclide filling defect detected by stressed 201TI-SPECT perfusion imaging. In patients with late hyperenhancement in MSCT, 99mTc-MIBI imaging showed incomplete nuclide filling. By contrast, the complete nuclide filling was shown on 99mTc-MIBI imaging in patients without late hyperenhancement on MSCT scan. Figure 3 shows an example of a large perfusion defect on MSCT and SPECT.

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