Comparison between low-dose multidetector computed coronary angiography and myocardial perfusion imaging test in patients with intermediate pre-test likelihood of coronary artery disease.

摘要

Multidetector computed tomography (MDCT) is a new method in the evaluation of patients with intermediate pre-test likelihood of coronary artery disease (CAD) [1-3], but it fails to provide the functional relevance of CAD [4], Exercise/rest myocardial perfusion imaging (MPI) is an established technique for assessment of the functional significance of CAD [5] but it is of limited utility in the diagnosis of non-obstructive stenoses [6]. The aims of this study were to examine the complementary role of these two techniques in symptomatic patients with intermediate pre-test likelihood of CAD.We enrolled eighty consecutive patients with intermediate pre-test likelihood of CAD according to Diamond criteria [7], referred to our hospital for invasive coronary angiography (1CA). All patients had an exercise/rest technetium 99 m-sestamibi MPI performed within 3 months (mean time 24 +-6 days) according to the standard American Society of Nuclear Cardiology [8] considering the effective radiation dose (ED) of MPI as 10 mSv [9]. Five patients were excluded from the study because the target HR was not reached despite the use of i.v. metoprolol before MDCT. Thus a total of 75 patients were included in the study (age 57 +-8 years; 57 male) (Table 1). The institutional review board and ethic committee approved the study protocol. All patients provided written informed consent.