Comparison of coronary CTA and stress/rest myocardial perfusion scan (offline image fusion) in patients with recurrent coronary artery disease
Abstract
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. 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%. 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.