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Updated: Jul 8, 2026

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
06:02

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

Published on: April 18, 2013

Anatomic correlates of a normal perfusion scan using 64-slice computed tomographic coronary angiography

Jacob M van Werkhoven1, Joanne D Schuijf, J Wouter Jukema

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. j.m.van_werkhoven@lumc.nl

The American Journal of Cardiology
|December 26, 2007
PubMed

Insights

Myocardial perfusion imaging (MPI) can appear normal even with coronary artery disease (CAD). Multislice computed tomography (MSCT) can reveal anatomic findings in patients with normal MPI, though high-risk CAD is rare.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Myocardial perfusion imaging (MPI) and multislice computed tomography (MSCT) are diagnostic tools for coronary artery disease (CAD).
  • MSCT can detect early atherosclerosis before myocardial perfusion abnormalities appear.
  • Normal MPI results do not always exclude significant CAD, including high-risk conditions like left main or 3-vessel disease.

Purpose of the Study:

  • To evaluate the range of coronary artery anatomic findings using MSCT in patients with normal MPI results.
  • To determine the prevalence of normal coronary arteries, nonobstructive CAD, and obstructive CAD in patients with normal MPI.
  • To assess the occurrence of high-risk CAD (left main and 3-vessel disease) in this patient group.

Main Methods:

  • 180 patients presenting with chest pain underwent both MPI (gated single-photon emission computed tomography) and 64-slice MSCT.
  • Coronary artery anatomy was assessed by MSCT in patients with normal MPI findings.
  • Prevalence of normal arteries, nonobstructive CAD, obstructive CAD, and high-risk CAD was determined.

Main Results:

  • Of 97 patients with normal MPI, 38 (39%) had normal coronary anatomy.
  • Nonsignificant CAD was found in 37 patients (38%), and significant CAD in 18 patients (19%).
  • Only 4 patients (4%) had high-risk CAD (2 left main, 2 three-vessel disease).

Conclusions:

  • Normal MPI results can coexist with a spectrum of coronary artery disease, from normal anatomy to obstructive CAD.
  • MPI alone cannot rule out the presence of nonobstructive or obstructive coronary artery disease.
  • High-risk coronary artery disease was uncommon in patients with normal MPI findings.

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