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Correlation of myocardial perfusion SPECT with 64 slice MSCT and combination with invasive coronary angiogram in patients not known to have CAD

¹ Nuclear Medicine, Apollo Hospitals, Chennai, Tamilnadu, India

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Objectives: The aim of this study was to compare Multislice computed tomography (MSCT) with myocardial perfusion single photon emission computed tomography (MPS) and also to compare the non-invasive findings with that of invasive coronary angiogram (CAG) in patients previously not known to have coronary artery disease (CAD).

Methods: A total of 79 patients underwent both MSCT and MPS. The MSCT studies were classified as having no CAD, significant CAD (lumen narrowing >50%) and insignificant CAD (lumen narrowing <50%). MPS were reported as normal, reversible ischemia or fixed defects. In a subgroup of 26 patients invasive CAG was done.

Results: In 79 patients, 316 coronaries were evaluated with MSCT and MPS. Calcium scoring in these patients ranged from 0 to 2200. No CAD was seen in 126 (40%) coronaries and MPS was normal. Insignificant CAD was seen in 126 (40%) coronaries amongst which reversible ischemia was noted in 16 (13%). Significant CAD was seen in 64 (20%) coronaries of which only 35 (53%) were MPS positive. MSCT had a NPP value of 94%. When MSCT was normal, MPS was mostly normal, whereas when MPS was normal MSCT was not always normal but showed lesions of insignificant obstruction. In the subset of 26 patients who underwent CAG, 104 coronaries were evaluated. CAG showed 36 coronaries to have significant CAD. MSCT correlated well in 32 (84%) with P value < 0.001(in 2 test) but for 7 (16%) showing overestimation due to increased calcium scoring (>800) with an accuracy of 90%. MPS was still normal in 9 (25%) coronaries.

Conclusions: MSCT and CAG provide anatomical information on CAD and correlates well. MSCT has high negative predictive value.MPS provides the functional significance of the anatomical lesions.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Simon, S. Articles by Deshpande, P. PubMed Articles by Simon, S. Articles by Deshpande, P.