Additional diagnostic value of first-pass myocardial perfusion imaging without stress when combined with 64-row detector coronary CT angiography in patients with coronary artery disease

Kazuhiro Osawa, Toru Miyoshi, Yasushi Koyama, Katsushi Hashimoto, Shuhei Sato, Kazufumi Nakamura, Nobuhiro Nishii, Kunihisa Kohno, Hiroshi Morita, Susumu Kanazawa, Hiroshi Ito

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)

Abstract

Objective: Multi-detector coronary CT angiography (CCTA) can detect coronary stenosis, but it has a limited ability to evaluate myocardial perfusion. We evaluated the usefulness of first-pass CT-myocardial perfusion imaging (MPI) in combination with CCTA for diagnosing coronary artery disease (CAD). Methods: A total of 145 patients with suspected CAD were enrolled. We used 64-row multi-detector CT (Definition Flash, Siemens). The same coronary CCTA data were used for first-pass CT-MPI without drug loading. Images were reconstructed by examining the signal densities at diastole as colour maps. Diagnostic accuracy was assessed by comparison with invasive coronary angiography. Results: First-pass CT-MPI in combination with CCTA significantly improved diagnostic performance compared with CCTA alone. With per-vessel analysis, the sensitivity, specificity, positive predictive value and negative predictive value increased from 81% to 85%, 87% to 94%, 63% to 79% and 95% to 96%, respectively. The area under the receiver operating characteristic curve for detecting CAD also increased from 0.84 to 0.89 (p=0.02). First-pass CT-MPI was particularly useful for assessing segments that could not be directly evaluated due to severe calcification and motion artefacts. Conclusions: First-pass CT-MPI has an additional diagnostic value for detecting coronary stenosis, in particular in patients with severe calcification.

Original languageEnglish
Pages (from-to)1008-1015
Number of pages8
JournalHeart
Volume100
Issue number13
DOIs
Publication statusPublished - Jul 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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