Combined analysis of stress myocardial perfusion SPECT and coronary CT angiography in the identification of the ischemia-related coronary artery.

Fiche publication


Date publication

décembre 2010

Auteurs

Membres identifiés du Cancéropôle Est :
Pr KARCHER Gilles


Tous les auteurs :
Didot N, Daragon N, Djaballah W, Mandry D, Gillet N, Koehl G, Meneroux B, Netter F, Grandpierre S, Regent D, Karcher G, Marie PY

Résumé

The Identification of ischemia related coronary artery by stress myocardial perfusion SPECT (SPECT MPS) is difficult but it is likely that this identification could be easier by fusionning the SPECT images with images from coronary CT angiography (CTA) Objective To assess the usefulness of the fusion of SPECT-MPS images with CTA images in the identification of ischemia-related coronary arteries Method SPECT MPS and CTA which had been recorded in a delay 70 %) at CTA In case of discordance between the two techniques an analysis was performed while fusioning the SPECT MPS and CTA images Results The population included 38 patients of whom 22 (58 %) had an ischemia at SPECT-MPS The identification of the ischemia related vessels was initially discordant between SPECT MPS and CTA for 17 patients (45 %) After the fusion's analysis nine out of these 17 patients (53 %) became totally concordant because of modifications in the CTA analysis in six patients and in the SPECT-MPS analysis in only three A low severity of ischemia was the main correlate of persisting discordances after fusion 58 % (7/12) of such low severity ischemia were observed in coronary vessels with persisting discordance, but only 24 % (5/27) with concordant coronary vessels (p = 0 02) Conclusion The identification with SPECT MPS of the ischemia-related coronary artery is rarely modified by a fusion analysis with CTA images Discordances between the two techniques remain frequent, even after fusion but especially in case of low severity SPECT-MPS ischemias (C) 2010 Elsevier Masson SAS All rights reserved

Référence

Med Nucl-imag Fonct Metab. 2010 Dec;34(12):637-46.