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Relationship Between Noninvasive Coronary Angiography With Multi-Slice Computed Tomography and Myocardial Perfusion Imaging

Joanne D. Schuijf, MSc^_*,,, William Wijns, MD, PhD, J. Wouter Jukema, MD, PhD^_*,, Douwe E. Atsma, MD, PhD^_*, Albert de Roos, MD, PhD, Hildo J. Lamb, MD, PhD, Marcel P.M. Stokkel, MD, PhD^||, Petra Dibbets-Schneider, MSc^||, Isabel Decramer, MSc^,¶, Pieter De Bondt, MD, PhD^#, Ernst E. van der Wall, MD, PhD^_*,, Piet K. Vanhoenacker, MD^¶ and Jeroen J. Bax, MD, PhD^_*,_*

^_* Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
The Interuniversity Institute of the Netherlands, Utrecht, the Netherlands
Cardiovascular Center, Aalst, Belgium
^|| Department of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
^¶ Department of Radiology and Medical Imaging, OLV Ziekenhuis, Aalst, Belgium
^# Division of Nuclear Medicine, OLV Ziekenhuis, Aalst, Belgium

View larger version (5K): [in this window] [in a new window] [Download PPT slide]   Figure 1 Relation between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) results. Of note, the MSCT abnormal population includes both patients with nonobstructive and obstructive coronary artery disease.

View larger version (5K): [in this window] [in a new window] [Download PPT slide]   Figure 2 Relation between MSCT and MPI results. Abbreviations as in Figure 1.

View larger version (97K): [in this window] [in a new window] [Download PPT slide]   Figure 3 Discrepancy between MSCT and MPI. Example of a 69-year-old man with an abnormal MSCT but no perfusion abnormalities on MPI. In A, C, and D, curved multiplanar MSCT reconstructions of, respectively, the left anterior descending coronary artery, the left circumflex coronary artery, and the right coronary artery are provided. B is an enlargement of the proximal part of the left anterior descending coronary artery perpendicular to A, whereas a 3-dimensional volume rendered reconstruction is provided in E. In all 3 coronary arteries, the presence of diffuse atherosclerosis can be observed. In F, however, short-axis (upper two rows), vertical long-axis (middle two rows), and horizontal long-axis (lower two rows) myocardial perfusion imaging during exercise (first, third, and fifth rows) and rest (second, fourth, and sixth rows) demonstrate homogeneous myocardial perfusion without perfusion defects. Abbreviations as in Figure 1.

View larger version (5K): [in this window] [in a new window] [Download PPT slide]   Figure 4 Relation between findings on multi-slice computed tomography (MSCT), myocardial perfusion imaging (MPI), and invasive coronary angiography (angio).