Ces radiol. 2011, 65(3):183-189

Comparison of coronary CTA and stress/rest myocardial perfusion scan (off-line image fusion) in patients with recurrent coronary artery diseaseOriginal article

Jan Baxa, Jiří Ferda, Alexandr Malán, Jan Záhlava, Boris Kreuzberg
Klinika zobrazovacích metod LF UK a FN, Plzeň

Aim: Aim of this retrospective study was to define the feasibility of coronary CTA (cCTA) in combination with stress/rest myocardial perfusion scan (MPS) in patients with recurrence of coronary artery disease (CAD).

Method: We performed retrospective evaluation of 63 patients with known CAD (42 patients after bypass surgery - CABG, 8 patients after PTCA and 13 patients with conservative therapy). All patients underwent cCTA (dual source CT somatom Definition, Siemens, Germany) and stress/rest MPS (using (99mTc-MIBI) due to new-onset of CAD symptoms within a time period of 3 months. 37 patients underwent cCTA before MPS whereas 26 patients were indicated on the base of results of MPS. In analysis we concentrated on agreement between both methods, concretely if cCTA proved involvement (hemodynamic stenosis or complete occlusion) of coronary branch or CABG corresponding with localization of stress induced perfusion defect.

Results: Generally agreement between methods was 84.5%, in the group of patients after CABG was almost 92.8%. In 46 patients (73.1%) was cCTA only imaging method and subsequent invasive coronary angiography (ICA) was not performed, 10 patients subsequently underwent the stent implantation and 2 patients were indicated to CABG. Sensitivity of cCTA in proving correspondent changes with perfusion defects was 94.8% (specificity 66.7%, PPV 82.2% and NPV 88.9%). In group of patient after CABG was sensitivity of cCTA 100%.

Conclusion: Combination of cCTA and MPS is beneficial in patients with recurrent coronary artery disease. In our study cCTA proved excellent capability to define cause or predict stress induced myocardial perfusion defects in symptomatic patients.

Keywords: coronary CTA, myocardial perfusion scan, offline vision, recurrent CHD
Grants and funding:

Práce byla podpořena výzkumným projektem MSM 0021620819.

Accepted: March 15, 2011; Published: September 1, 2011  Show citation

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Baxa J, Ferda J, Malán A, Záhlava J, Kreuzberg B. Comparison of coronary CTA and stress/rest myocardial perfusion scan (off-line image fusion) in patients with recurrent coronary artery disease. Ces radiol. 2011;65(3):183-189.
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