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Sixty-four-slice computed tomography coronary angiography compared with myocardial perfusion scintigraphy for the diagnosis of functionally significant coronary stenoses in patients with a low to intermediate likelihood of coronary artery disease.
- Source :
-
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology [J Nucl Cardiol] 2008 May-Jun; Vol. 15 (3), pp. 311-8. Date of Electronic Publication: 2008 Apr 16. - Publication Year :
- 2008
-
Abstract
- Background: Multislice computed tomography coronary angiography (CTA) was proposed as a method for investigating possible coronary artery disease (CAD) in patients who present with chest pain but with a low to intermediate likelihood of CAD. Sixty-four-channel CTA was compared prospectively with (99m)Tc-tetrofosmin myocardial perfusion scintigraphy (MPS) (as the gold standard in the detection of flow-limiting stenoses) for the detection of functionally significant CAD.<br />Methods and Results: Fifty-two consecutive symptomatic patients with a low to intermediate likelihood of coronary artery disease, and who were referred for MPS, also underwent CTA. The CTA datasets were analyzed by two experienced observers who were blinded to the MPS data, and coronary artery segments were reported as < 50%, 50% to 69%, 70% to 99% stenoses, or occluded. The MPS images were similarly analyzed for inducible perfusion abnormalities, and coronary territories were identified. At the patient level, agreement between CTA and MPS for CTA lesions at >/= 50% was 87% (sensitivity, 100%; specificity, 84%; positive predictive value, 50%; negative predictive value, 100%). For CTA lesions, agreement at >/= 70% was 96% (sensitivity, 86%; specificity, 98%; positive predictive value, 86%; negative predictive value, 98%).<br />Conclusions: In patients with a low to intermediate likelihood of CAD, there is good correlation between MPS and CTA for the detection of functionally significant coronary artery stenoses when CTA detects a narrowing of >/= 70% severity. Computed tomography coronary angiography stenoses of 70% should be used to determine functional significance, and not 50%, as is the usual practice at present.
- Subjects :
- Female
Humans
Male
Middle Aged
Prognosis
Radionuclide Imaging
Risk Factors
Coronary Angiography methods
Coronary Artery Disease diagnostic imaging
Coronary Stenosis diagnostic imaging
Patient Selection
Radiographic Image Enhancement methods
Risk Assessment methods
Tomography, X-Ray Computed methods
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6551
- Volume :
- 15
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 18513637
- Full Text :
- https://doi.org/10.1016/j.nuclcard.2008.02.017