Diagnostic efficiency of 64-slice CT angiography of myocardial perfusion to myocardial ischemia of coronary stenosis
10.3321/j.issn:1003-3289.2009.10.042
- VernacularTitle:64排螺旋CT心肌灌注显像评价冠状动脉狭窄对心肌缺血的诊断效能
- Author:
Hongming ZHENG
;
Yingmin CHEN
;
Jue FENG
;
Fengning FANG
- Publication Type:Journal Article
- Keywords:
Coronary angiography;
Myocardial perfusion imaging;
Coronary disease;
Myocardial ischemia;
Tomography;
X-ray computed
- From:
Chinese Journal of Medical Imaging Technology
2009;25(10):1883-1887
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic efficiency of 64-slice CT coronary angiography (CTCA) to myocardial ischemia of coronary stenosis. Methods ~(99m) Tc-MIBI myocardial perfusion imaging (MPI) and 64-slice CTCA were performed in 30 patients with myocardial ischemia of coronary stenosis. Three coronary arteries were divided in to 12 segments in each patient, the diagnostic efficiency of CTCA to myocardial ischemia of coronary stenosis were eveluated taking MPI as diagnostic standard, and stenoses ≥50% and ≥75% as the cutoff value. Results In 9 patients, perfusion defected were found (6 reversible, 3 fixed) on MPI. A total of 327 coronary arteries' segments were analyzed, quantitative CTCA revealed stenoses ≥50% in 25 segments (7.65%) and stenoses ≥75% in 12 segments (3.67%). When the cut-off was ≥50%, the sensitivity, specificity, negative and positive predictive value (NPV, PPV) and accuracy of CTCA by the abnormal images of MPI as diagnostic standard to observe abnormal arteries was 68.42%, 96.14%, 99.01%, 52.00% and 95.41%, respectively; and 66.67%, 99.04%, 98.73%, 66.67% and 97.55%, respectively, when cut-off at ≥75%. Taking abnormal MPI as diagnostic standard to observe the patients, the sensitivity, specificity, NPV, PPV and accuracy of CTCA was 66.67%, 57.14%, 80.00%, 40.00% and 60.00% respectively, with the cut-off at ≥50%; and was 55.56%, 85.71%, 81.82%, 62.50% and 76.67%, respectively, with the cut-off at ≥75%.Conclusion Sixty-four-slice CTCA is a reliable tool to rule out functionally relevant myocardial ischemia of coronary artery disease. However, further examination is necessory for patients with abnormal CTCA.
