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

DOI Web Site Web Site PubMed 被引用文献17件 参考文献26件
  • Shiraishi Shinya
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University
  • Sakamoto Fumi
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University
  • Tsuda Noriko
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University
  • Yoshida Morikatsu
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University
  • Tomiguchi Seiji
    Department of Diagnostic Medical Imaging, School of Health Faculty of Life Sciences, Kumamoto University
  • Utsunomiya Daisuke
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University
  • Ogawa Hisao
    Department of Cardiovascular Medicine, Graduate School of Life Sciences, Kumamoto University
  • Yamashita Yasuyuki
    Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University

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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. (Circ J 2015; 79: 623–631)

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  • Circulation Journal

    Circulation Journal 79 (3), 623-631, 2015

    一般社団法人 日本循環器学会

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