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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Single-photon emission computed tomography myocardial perfusion imaging in the diagnosis of left main disease

Luis Afonso1, Nitin Mahajan

  • 1Division of Cardiology and Department of Internal Medicine, DetroitMedical Center, Wayne State University School of Medicine, Detroit, Michigan 48201, USA. lafonso@med.wayne.edu

Clinical Cardiology
|December 17, 2009
PubMed

Insights

Single-photon emission computed tomography (SPECT) imaging can diagnose left main disease (LMD), but nearly 19% of patients show no reversible perfusion defects. Abnormalities like one-vessel distribution perfusion defects and transient ischemic dilatation are most common.

Area of Science:

  • Cardiology
  • Nuclear Cardiology
  • Diagnostic Imaging

Background:

  • Left main disease (LMD) affects 3-5% of patients undergoing cardiac catheterization.
  • Limited data exists on the diagnostic value of single-photon emission computed tomography (SPECT) for LMD.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of SPECT imaging in identifying left main disease.
  • To analyze SPECT findings in patients with isolated LMD and multi-vessel disease.

Main Methods:

  • Retrospective analysis of 74 patients with LMD diagnosed between January 2003 and December 2007.
  • SPECT imaging (exercise or adenosine stress) using Thallium-201 or Tc-99m was performed within 6 months of angiography.
  • Patients were divided into Group 1 (isolated LMD, n=33) and Group 2 (LMD with other coronary artery disease, n=41).

Main Results:

  • Reversible perfusion defects (PD) were absent in 18-20% of patients.
  • One-vessel distribution PD was the most frequent abnormality (61% in Gp 1, 49% in Gp 2).
  • Left main pattern was rare (6 patients); transient ischemic dilatation (TID) occurred in 34 patients.

Conclusions:

  • SPECT imaging is a valuable tool for diagnosing LMD, even in cases without reversible PD.
  • One-vessel distribution PD and TID are the most common SPECT abnormalities in LMD.
  • This study provides the largest analysis of SPECT findings in patients with isolated LMD.
Abstract

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