| Dipyridamole stress and rest myocardial perfusion by 64-detector row computed tomography in patients with suspected coronary artery disease. | |
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MedLine Citation:
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PMID: 20643238 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Recently, stress myocardial computed tomographic perfusion (CTP) was shown to detect myocardial ischemia. Our main objective was to evaluate the feasibility of dipyridamole stress CTP and compare it to single-photon emission computed tomography (SPECT) to detect significant coronary stenosis using invasive conventional coronary angiography (CCA; stenosis >70%) as the reference method. Thirty-six patients (62 +/- 8 years old, 20 men) with previous positive results with SPECT (<2 months) as the primary inclusion criterion and suspected coronary artery disease underwent a customized multidetector-row CT protocol with myocardial perfusion evaluation at rest and during stress and coronary CT angiography (CTA). Multidetector-row computed tomography was performed in a 64-slice scanner with dipyridamole stress perfusion acquisition before a second perfusion/CT angiographic acquisition at rest. Independent blinded observers performed analysis of images from CTP, CTA, and CCA. All 36 patients completed the CT protocol with no adverse events (mean radiation dose 14.7 +/- 3.0 mSv) and with interpretable scans. CTP results were positive in 27 of 36 patients (75%). From the 9 (25%) disagreements, 6 patients had normal coronary arteries and 2 had no significant stenosis (8 false-positive results with SPECT, 22%). The remaining patient had an occluded artery with collateral flow confirmed by conventional coronary angiogram. Good agreement was demonstrated between CTP and SPECT on a per-patient analysis (kappa 0.53). In 26 patients using CCA as reference, sensitivity, specificity, and positive and negative predictive values were 88.0%, 79.3%, 66.7%, and 93.3% for CTP and 68.8, 76.1%, 66.7%, and 77.8%, for SPECT, respectively (p = NS). In conclusion, dipyridamole CT myocardial perfusion at rest and during stress is feasible and results are similar to single-photon emission CT scintigraphy. The anatomical-perfusion information provided by this combined CT protocol may allow identification of false-positive results by SPECT. |
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Authors:
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Roberto C Cury; Tiago A Magalhães; Anna C Borges; Afonso A Shiozaki; Pedro A Lemos; José Soares Júnior; José Cláudio Meneghetti; Ricardo C Cury; Carlos E Rochitte |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-20 Completed Date: 2010-08-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 310-5 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Cardiovascular MR and CT Section, University of São Paulo Medical, School, São Paulo, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography Coronary Artery Disease / diagnosis*, radiography, radionuclide imaging Dipyridamole / diagnostic use* Exercise Test Female Heart Catheterization Humans Male Middle Aged Predictive Value of Tests Prospective Studies Radiation Dosage Rest Sensitivity and Specificity Tomography, Emission-Computed, Single-Photon Tomography, Spiral Computed* Vasodilator Agents / diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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