[Comparison of myocardial perfusion assessed by Tc99m MIBI single photon emission computer tomography (SPECT) with...

There is growing evidence regarding evaluation of Coronary Artery Calcium Score (CS) using the multi-slice computer tomography (MSCT), but as a new method it still need for verification in comparison with other, non-invasive modalities, with established rationale. One of these is SPECT, which value in evaluation of patients with coronary artery disease is well known. We tried to compare these two studies and their usefulness in diagnosis of patients with confirmed coronary artery disease.

72 patients (53 males and 19 females, mean age 59.9 +/- 8.66), all after coronary angiography, with coronary artery disease (CCS II or III) were included into our study. SPECT and exercise treadmill results were compared with the coronary artery calcium score (CS) as assessed by MSCT. Both studies were performed with maximal 7-days intervals at most between the studies. Image reconstruction was performed using the Autoperfusion protocol, with the VISUAL Score analysis (5-point scale) of extent of perfusion defect. MSCT was evaluated using the Calcium Score protocol. For the statistical analysis we used Student's T-test and Pearson correlation analysis.

The correlation between total CS and the score of the reversible and non-reversible perfusion defects in Tc 99mMIBI SPECT was not found. Following the analysis for the 3 main coronary arteries separately, and number of perfusion defects, a correlation was observed for LAD and RCA perfusion regions.

1. Statistically significant correlation between CS by MSCT and SPECT perfusion deficiencies in the left descending artery (LAD) and right coronary artery (RCA) perfusion regions were found. 2. The correlation between high CS (>400) and the presence of hemodynamically significant changes in coronary angiography was found. 3. We conclude that CS by MSCT may be a screening-tool of some value for risk stratification.