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Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging.

Abstract：

OBJECTIVES:The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography. BACKGROUND:Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown. METHODS:A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. The MSCT studies were classified as having no CAD, nonobstructive (<50% luminal narrowing) CAD, or obstructive CAD. Myocardial perfusion imaging examinations were classified as showing normal or abnormal (reversible and/or fixed defects). In a subset of 58 patients, invasive coronary angiography was performed. RESULTS:On the basis of the MSCT data, 41 patients (36%) were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients (29%) showed non-obstructive CAD, whereas at least 1 significant (> or =50% luminal narrowing) lesion was observed in the remaining 40 patients (35%). Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%). CONCLUSIONS:Myocardial perfusion imaging and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. As compared to invasive angiography, MSCT has a high accuracy for detecting CAD in patients with an intermediate likelihood of CAD.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Schuijf JD,Wijns W,Jukema JW,Atsma DE,de Roos A,Lamb HJ,Stokkel MP,Dibbets-Schneider P,Decramer I,De Bondt P,van der Wall EE,Vanhoenacker PK,Bax JJ

doi

10.1016/j.jacc.2006.05.080

subject

Has Abstract

pub_date

2006-12-19 00:00:00

pages

2508-14

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(06)02209-1

journal_volume

pub_type

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Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging.