Document Detail

Detection of coronary artery disease using real-time myocardial contrast echocardiography: a comparison with dual-isotope resting thallium-201/stress technectium-99m sestamibi single-photon emission computed tomography.
MedLine Citation:
PMID:  16865298     Owner:  NLM     Status:  MEDLINE    
Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6%) by MCE, in 29 patients (41.4%) by WM analysis, and in 30 patients (42.9%) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7% (Kappa = 0.50) to 82.0% (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84%), specificity (93.3%), and accuracy (87.5%) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.
Shoa-Lin Lin; Kuan-Rau Chiou; Wei-Chun Huang; Nan-Jing Peng; Daw-Guey Tsay; Chun-Peng Liu
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart and vessels     Volume:  21     ISSN:  0910-8327     ISO Abbreviation:  Heart Vessels     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-25     Completed Date:  2007-02-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8511258     Medline TA:  Heart Vessels     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  226-35     Citation Subset:  IM    
Department of Internal Medicine, Division of Cardiology, Kaohsiung Veterans General Hospital, 386 Dar-Chung 1st Road, Kaohsiung, 813, Taiwan.
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MeSH Terms
Coronary Angiography
Coronary Artery Disease / radiography,  radionuclide imaging,  ultrasonography*
Dipyridamole / administration & dosage
Echocardiography / methods*
Heart / radionuclide imaging
Middle Aged
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Vasodilator Agents / administration & dosage
Reg. No./Substance:
0/Thallium Radioisotopes; 0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi; 58-32-2/Dipyridamole

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