Prediction of Left Main or 3-Vessel Disease Using Myocardial Perfusion Reserve on Dynamic Thallium-201 Single-Photon Emission Computed Tomography With a Semiconductor Gamma Camera

被引:60
作者
Shiraishi, Shinya [1 ]
Sakamoto, Fumi [1 ]
Tsuda, Noriko [1 ]
Yoshida, Morikatsu [1 ]
Tomiguchi, Seiji [2 ]
Utsunomiya, Daisuke [1 ]
Ogawa, Hisao [3 ]
Yamashita, Yasuyuki [1 ]
机构
[1] Kumamoto Univ, Grad Sch Life Sci, Dept Diagnost Radiol, Kumamoto 8608556, Japan
[2] Kumamoto Univ, Dept Diagnost Med Imaging, Sch Hlth Fac Life Sci, Kumamoto, Japan
[3] Kumamoto Univ, Dept Cardiovasc Med, Grad Sch Life Sci, Kumamoto, Japan
关键词
Balanced ischemia; Myocardial perfusion reserve; Semiconductor gamma camera; Thallium-201; Three-vessel disease; TRANSIENT ISCHEMIC DILATION; CORONARY-ARTERY-DISEASE; FLOW RESERVE; WALL-MOTION; BLOOD-FLOW; SPECT; QUANTIFICATION; PET; TRACER; PLAQUE;
D O I
10.1253/circj.CJ-14-0932
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Myocardial perfusion imaging (MPI) may fail to detect balanced ischemia. We evaluated myocardial perfusion reserve (MPR) using Tl dynamic single-photon emission computed tomography (SPECT) and a novel cadmium zinc telluride (CZT) camera for predicting 3-vessel or left main coronary artery disease (CAD). Methods and Results: A total of 55 consecutive patients with suspected CAD underwent SPECT-MPI and coronary angiography. The MPR index was calculated using the standard 2-compartment kinetic model. We analyzed the utility of MPR index, other SPECT findings, and various clinical variables. On multivariate analysis, MPR index and history of previous myocardial infarction (MI) predicted left main and 3-vessel disease. The area under the receiver operating characteristic curve was 0.81 for MPR index, 0.699 for history of previous MI, and 0.86 for MPR index plus history of previous MI. MPR index <= 1.5 yielded the highest diagnostic accuracy. Sensitivity, specificity, and accuracy were 86%, 78%, and 80%, respectively, for MPR index, 64%, 76%, 73% for previous MI, and 57%, 93%, and 84% for MPR index plus history of previous MI. Conclusions: Quantification of MPR using dynamic SPECT and a novel CZT camera may identify balanced ischemia in patients with left main or 3-vessel disease.
引用
收藏
页码:623 / 631
页数:9
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