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Correlation of Morphological and Functional Cardiac Images: Fusion of Myocardial Perfusion SPECT and CT Angiography
Hüseyin Şan1, Alper Özgür Karaçalıoğlu2, Uğur Bozlar3
1University of Health Sciences Turkey, Ankara City Hospital, Clinic of Nuclear Medicine, Ankara, Turkey.
Insights
Cardiac hybrid imaging (CHI) effectively detects hemodynamically significant coronary stenosis in patients with multiple coronary artery disease and perfusion defects. This fusion of functional and anatomic imaging offers valuable diagnostic insights.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Coronary artery stenosis poses a significant risk for cardiac events.
- Accurate detection of hemodynamically significant stenosis is crucial for patient management.
- Multiple coronary stenosis presents diagnostic challenges.
Purpose of the Study:
- To evaluate the diagnostic value of cardiac hybrid imaging (CHI) in identifying hemodynamically significant coronary stenosis.
- To assess CHI's performance in patients with multiple coronary stenosis and perfusion defects.
Main Methods:
- A study included 36 patients with ischemia/infarction on gated myocardial perfusion single-photon emission computed tomography (gMPS) and multiple coronary stenosis on coronary computed tomography angiography (CCTA).
- Patients also underwent invasive coronary angiography (ICA).
- Statistical analyses, including the McNemar test, were used to compare CCTA, ICA, and CHI in detecting significant stenoses.
Main Results:
- Total accordance between gMPS and CHI in identifying perfusion-defect-related coronary arteries was observed in 50% of patients, with partial accordance in 36.1%.
- No statistically significant differences were found when comparing CCTA and ICA, or CCTA and CHI, or ICA and CHI in detecting anatomically and hemodynamically significant stenoses in major coronary arteries (LAD, LCx, RCA).
Conclusions:
- Cardiac hybrid imaging (CHI) can directly detect hemodynamically significant coronary stenosis.
- CHI is a valuable tool for diagnosing coronary artery stenosis in patients with multiple lesions and perfusion defects.
Objectives:
The current study evaluates the value of cardiac hybrid imaging (CHI), performed by the fusion of functional and anatomic cardiac images, in the detection of hemodynamically significant coronary stenosis in cases with multiple coronary stenosis.
Methods:
A total of 36 patients (10 female, 26 male) in whom ischemia or infarction was detected on gated myocardial perfusion single photon emission computed tomography (gMPS) and multiple coronary stenosis were concomitantly detected on coronary computed tomography angiography (CCTA) and undergone invasive coronary angiography (ICA) was included in this study. Statistical analyses were performed using SPSS 22 Windows software. McNemar test was applied to show concordance between coronary CT angiography, ICA and CHI in the detection of anatomically or hemodynamically significant stenosis in three major coronary arteries. Comparison results of coronary arteries responsible for perfusion defects on CHI and gMPS are presented as percentages (%).
Results:
There was total accordance between coronary arteries leading to perfusion defects detected by gMPS and CHI in 50% of patients. It was observed a partial accordance in 36.1% of the patients. Additionally, it was also detected perfusion defects originated from side branches in 25% of the patients. Between results of CCTA and ICA, no statistically significant difference was noted in the detection of anatomically significant stenoses in the left main coronary artery, left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) (p=1.000, 0.070, 0.549, and 1.000, respectively). In addition, no statistically significant difference was found in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by CCTA and CHI (p=0.344, 0.629, and 0.219, respectively). No statistically significant difference was observed in the detection of anatomically and hemodynamically significant stenoses in LAD, LCx and RCA by ICA and CHI (p=0.804, 1.000, and 0.344, respectively).
Conclusion:
It is possible to detect hemodynamically significant coronary stenosis directly by CHI modality in patients with multiple coronary stenosis, wide perfusion defects.
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