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- [42] ZWEIG MH, 1993, CLIN CHEM, V39, P561
Diagnostic accuracy of combined coronary angiography and adenosine stress myocardial perfusion imaging using 320-detector computed tomography: pilot study
被引：47
作者：
Nasis, Arthur
[1
,2
]
Ko, Brian S.
[1
,2
]
Leung, Michael C.
[1
,2
]
Antonis, Paul R.
[1
,2
]
Nandurkar, Dee
[3
]
Wong, Dennis T.
[1
,2
]
Kyi, Leo
[1
,2
]
Cameron, James D.
[1
,2
]
Troupis, John M.
[3
]
Meredith, Ian T.
[1
,2
]
Seneviratne, Sujith K.
[1
,2
]
机构：
[1] Southern Hlth, Dept Med, Monash Med Ctr MMC, Monash Cardiovasc Res Ctr,Monash Heart, Melbourne, Vic, Australia
[2] Monash Univ, Melbourne, Vic 3004, Australia
[3] Southern Hlth, MMC, Dept Diagnost Imaging, Melbourne, Vic, Australia
基金：
英国医学研究理事会;
关键词：
Coronary artery disease;
Multidetector computed tomography;
Adenosine stress myocardial perfusion;
Single-photon emission computed tomography;
Myocardial ischaemia;
FRACTIONAL FLOW RESERVE;
MEDICAL THERAPY;
ARTERY STENOSIS;
CT PERFUSION;
ISCHEMIA;
REVASCULARIZATION;
PERFORMANCE;
CARDIOLOGY;
OUTCOMES;
DISEASE;
D O I：
10.1007/s00330-013-2788-z
中图分类号：
R8 [特种医学];
R445 [影像诊断学];
学科分类号：
1002 ;
100207 ;
1009 ;
摘要：
To determine the diagnostic accuracy of combined 320-detector row computed tomography coronary angiography (CTA) and adenosine stress CT myocardial perfusion imaging (CTP) in detecting perfusion abnormalities caused by obstructive coronary artery disease (CAD). Twenty patients with suspected CAD who underwent initial investigation with single-photon-emission computed tomography myocardial perfusion imaging (SPECT-MPI) were recruited and underwent prospectively-gated 320-detector CTA/CTP and invasive angiography. Two blinded cardiologists evaluated invasive angiography images quantitatively (QCA). A blinded nuclear physician analysed SPECT-MPI images for fixed and reversible perfusion defects. Two blinded cardiologists assessed CTA/CTP studies qualitatively. Vessels/territories with both > 50 % stenosis on QCA and corresponding perfusion defect on SPECT-MPI were defined as ischaemic and formed the reference standard. All patients completed the CTA/CTP protocol with diagnostic image quality. Of 60 vessels/territories, 17 (28 %) were ischaemic according to QCA/SPECT-MPI criteria. Sensitivity, specificity, PPV, NPV and area under the ROC curve for CTA/CTP was 94 %, 98 %, 94 %, 98 % and 0.96 (P < 0.001) on a per-vessel/territory basis. Mean CTA/CTP radiation dose was 9.2 +/- 7.4 mSv compared with 13.2 +/- 2.2 mSv for SPECT-MPI (P < 0.001). Combined 320-detector CTA/CTP is accurate in identifying obstructive CAD causing perfusion abnormalities compared with combined QCA/SPECT-MPI, achieved with lower radiation dose than SPECT-MPI. aEuro cent Advances in CT technology provides comprehensive anatomical and functional cardiac information. aEuro cent Combined 320-detector CTA/adenosine-stress CTP is feasible with excellent image quality. aEuro cent Combined CTA/CTP is accurate in identifying myocardial ischaemia compared with QCA/SPECT-MPI. aEuro cent Combined CTA/CTP results in lower patient radiation exposure than SPECT-MPI. aEuro cent CTA/CTP may become an established imaging technique for suspected CAD.
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页码：1812 / 1821
页数：10
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