Detection of moderate and severe coronary artery stenosis with technetium-99m tetrofosmin myocardial single-photon emission tomography
| Autor: | Gianmauro Sacchetti, Edgardo Pittaluga, Angelo S. Bongo, Franco Aina, Eugenio Inglese, Pierfranco Dellavesa, Carmelo Cernigliaro, Alberto Baroli, Marco Brambilla, Marco Rudoni |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Coronary Disease Single-photon emission computed tomography Coronary Angiography Scintigraphy Sensitivity and Specificity Organophosphorus Compounds Internal medicine medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Myocardial infarction Tomography Emission-Computed Single-Photon medicine.diagnostic_test Vascular disease business.industry Heart Organotechnetium Compounds General Medicine Middle Aged medicine.disease Stenosis medicine.anatomical_structure Right coronary artery Exercise Test Cardiology Female Radiopharmaceuticals business Emission computed tomography Artery |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging. 24:1230-1236 |
| ISSN: | 1619-7089 1619-7070 |
| DOI: | 10.1007/s002590050146 |
| Popis: | The aim of this study was to determine the diagnostic accuracy of technetium-99m tetrofosmin myocardial imaging for the localization of coronary artery stenoses of different degrees of severity. Stress-rest single-photon emission tomography (SPET) was performed on separate days in 80 patients (64 males, 16 females; mean age 61 years; 43 patients with previous myocardial infarction; 18 patients with pharmacological stress), within 6 months of coronary angiography. Scintigraphic images were blindly and independently evaluated by three observers. Coronary stenosis was defined as a >50% narrowing in luminal diameter; severe stenosis was defined as a proximal stenosis of >75% or a peripheral stenosis of >90%. Coronary angiography revealed normal coronary arteries or insignificant coronary stenosis in 13 patients and significant coronary stenoses in 67 patients. The sensitivity and specificity of 99mTc-tetrofosmin SPET in respect of severely stenosed vessels were, respectively, 80% and 65% for the left anterior descending artery (LAD), 100% and 46% for the right coronary artery (RCA) and 58 and 78% for the left circumflex artery (LCx) territories. Considering all the significantly stenosed vessels, a significant decrease in sensitivity was observed for LAD territories (to 59%, P=0.05), and a nonsignificant decrease for RCA (88%) and LCx (47%) territories while specificity values remained essentially unchanged. No significant changes in sensitivity or specificity were observed when regions with previous myocardial infarction were excluded. In conclusion, the sensitivity of 99mTc-tetrofosmin SPET for the localization of individual stenosed vessels is only moderate when all significant stenoses are considered, but the ability of this technique to predict the location of severe coronary artery stenoses seems satisfactory, with the exception of the low specificity in respect of RCA territories. |
| Databáze: | OpenAIRE |
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