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

被引:341
作者
Schuijf, Joanne D.
Wijns, William
Jukema, Wouter
Atsma, Douwe E.
de Roos, Albert
Lamb, Hildo J.
Stokkel, Marcel P. M.
Dibbets-Schneider, Petra
Decramer, Isabel
De Bondt, Pieter
van der Wall, Ernst E.
Vanhoenacker, Piet K.
Bax, Jeroen J.
机构
[1] Leiden Univ, Med Ctr, Dept Cardiol, NL-2333 ZA Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands
[3] Interuniv Inst Netherlands, Utrecht, Netherlands
[4] Cardiovasc Ctr, Aalst, Belgium
[5] Leiden Univ, Med Ctr, Dept Nucl Med, Leiden, Netherlands
[6] OLV, Dept Radiol & Med Imaging, Aalst, Belgium
[7] OLV, Div Nucl Med, Aalst, Belgium
关键词
D O I
10.1016/j.jacc.2006.05.080
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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, under-went 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 nom-obstructive CAD, whereas at least I significant (>= 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.
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收藏
页码:2508 / 2514
页数:7
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