Adenosine coronary vasodilation quantitative technetium 99m methoxy isobutyl isonitrile myocardial tomography in the identification and localization of coronary artery disease
| Autor: | Alberto Cuocolo, Stefania Cardei, Fiorenzo Squame, Peter J. Ell, L. Argenziano, Leonardo Pace, Antonio Nappi, Emanuele Nicolai, Marco Salvatore, Pasquale Sullo |
|---|---|
| Přispěvatelé: | Nicolai, E, Cuocolo, A, Pace, Leonardo, Nappi, A, Sullo, P, Cardei, S, Argenziano, L, Squame, F, Ell, Pj, Salvatore, M., Cuocolo, Alberto, Pace, L, Salvatore, Marco |
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Technetium Tc 99m Sestamibi medicine.medical_specialty Adenosine Vasodilator Agents Myocardial Infarction Blood Pressure Coronary Disease Single-photon emission computed tomography Coronary Angiography Sensitivity and Specificity Coronary artery disease Electrocardiography Heart Rate Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Cardiac imaging Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Heart Middle Aged medicine.disease Dipyridamole Cardiology Female Cardiology and Cardiovascular Medicine business Nuclear medicine Technetium-99m Perfusion Emission computed tomography medicine.drug |
| Popis: | Exercise and dipyridamole 99mTc-labeled methoxy isobutyl isonitrile (MIBI) myocardial scintigraphy have been widely used for the diagnosis of coronary artery disease (CAD). However, only limited data on adenosine 99mTc-labeled MIBI cardiac imaging are currently available. This study was designed to assess the accuracy of quantitative adenosine-rest 99mTc-labeled MIBI tomography in the diagnosis and localization of CAD.Fifty-seven consecutive patients with suspected CAD who underwent coronary angiography and 22 normal volunteers were studied. All patients underwent 99mTc-labeled MIBI tomography after administration of adenosine (140 micrograms/kg intravenously for 6 minutes) and at rest. A total of 171 vascular coronary territories were analyzed quantitatively. All patients with CAD (or = 50% luminal stenosis) (n = 55) had abnormal 99mTc-labeled MIBI tomograms. The normalcy rate was 86% by quantitative analysis. Overall sensitivity, specificity, and diagnostic accuracy for detection of individual stenosed vessels were 84%, 87%, and 85%, respectively. In patients with one-vessel CAD (n = 24), sensitivity and diagnostic accuracy in the detection of individual stenosed vessels were significantly (p0.05) higher compared with patients with multivessel CAD (n = 31). Moreover, 75% of patients with one-vessel disease showed a scintigraphic pattern characterized by the presence of perfusion defects in only one coronary artery territory, and 74% of patients with multivessel disease showed a scintigraphic pattern characterized by the presence of perfusion defects in two or more coronary artery territories. Sensitivity, specificity, and diagnostic accuracy for detecting individual diseased vessels were similar in patients without previous myocardial infarction (n = 18) compared with those with previous myocardial infarction (n = 39). In myocardial territories related to noninfarcted areas (n = 124), sensitivity and specificity in the detection of stenosed vessels were 75% and 88%. In infarcted areas (n = 47), sensitivity and specificity in the detection of stenosed vessels were 98% and 80% (differences not significant vs noninfarcted areas).Adenosine-controlled coronary vasodilation combined with quantitative 99mTc-labeled MIBI tomography is accurate for identifying patients with CAD and localizing individual stenosed coronary arteries. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|