Computed Tomography Myocardial Perfusion Imaging With 320-Row Detector Computed Tomography Accurately Detects Myocardial Ischemia in Patients With Obstructive Coronary Artery Disease
- 1 May 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation: Cardiovascular Imaging
- Vol. 5 (3), 333-340
- https://doi.org/10.1161/circimaging.111.969303
Abstract
Background—: Computed tomography coronary angiography (CTA) has been shown to be accurate in detecting anatomic coronary arterial obstruction, but is limited for the detection of myocardial ischemia. The primary aim of this study was to assess the accuracy of 320-row computed tomography perfusion imaging (CTP) to detect atherosclerosis causing myocardial ischemia. Methods and Results—: Fifty symptomatic patients with recent single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) underwent a comprehensive cardiac computed tomography (CT) protocol that included 320-CTA, followed by adenosine stress CTP. CTP images were analyzed quantitatively for the presence of subendocardial perfusion deficits. All analyses were blinded to imaging and clinical results. CTA alone was a limited predictor of myocardial ischemia compared with SPECT, with a sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of 56%, 75%, 56%, and 75%, and the area under the receiver operator characteristic curve (AUC) was 0.65 (95% CI, 0.51–0.78, P =0.07). CTP was a better predictor of myocardial ischemia, with a sensitivity, specificity, PPV, and NPV of 72%, 91%, 81%, and 85%, with an AUC of 0.81 (95% CI, 0.68–0.91, P P P =0.15). Conclusions—: Computed tomography perfusion imaging with rest and adenosine stress 320-row CT is accurate in detecting obstructive atherosclerosis causing myocardial ischemia.Keywords
This publication has 32 references indexed in Scilit:
- Diagnostic Performance of Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-MDCT: The CT Angiography and Perfusion Methods of the CORE320 Multicenter Multinational Diagnostic StudyAmerican Journal of Roentgenology, 2011
- Low Diagnostic Yield of Elective Coronary AngiographyNew England Journal of Medicine, 2010
- Incremental Value of Adenosine-induced Stress Myocardial Perfusion Imaging with Dual-Source CT at Cardiac CT AngiographyRadiology, 2010
- Adenosine-Induced Stress Myocardial Perfusion Imaging Using Dual-Source Cardiac Computed TomographyJournal of the American College of Cardiology, 2009
- Adenosine Stress 64- and 256-Row Detector Computed Tomography Angiography and Perfusion ImagingCirculation: Cardiovascular Imaging, 2009
- Coronary Computed Tomography Angiography for Early Triage of Patients With Acute Chest PainJournal of the American College of Cardiology, 2009
- Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64European Radiology, 2008
- MR-IMPACT: comparison of perfusion-cardiac magnetic resonance with single-photon emission computed tomography for the detection of coronary artery disease in a multicentre, multivendor, randomized trialEuropean Heart Journal, 2008
- Incremental value of prognostic testing in patients with known or suspected ischemic heart disease: A basis for optimal utilization of exercise technetium-99m sestamibi myocardial perfusion single-photon emission computed tomographyJournal of the American College of Cardiology, 1995
- Noninvasive assessment of coronary stenoses by myocardial perfusion imaging during pharmacologie coronary vasodilatationThe American Journal of Cardiology, 1978