Korean Journal of Radiology

  • 제18권3호
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  • Pages.476-486
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  • 2017
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Cardiac MRI

  • Chung, Hyun Woo (Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine) ;
  • Ko, Sung Min (Department of Radiology, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine) ;
  • Hwang, Hweung Kon (Department of Internal Medicine, Division of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • So, Young (Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine) ;
  • Yi, Jeong Geun (Department of Radiology, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine) ;
  • Lee, Eun Jeong (Department of Nuclear Medicine, Seoul Medical Center)
  • 투고 : 2016.02.23
  • 심사 : 2016.09.07
  • 발행 : 2017.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dualenergy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. Materials and Methods: We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ${\geq}50%$ stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. Results: For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were $0.84{\pm}0.05$, $0.85{\pm}0.05$, $0.79{\pm}0.06$, $0.89{\pm}0.04$, and $0.81{\pm}0.06$, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were $0.57{\pm}0.13$, $0.71{\pm}0.11$, $0.73{\pm}0.11$, $0.71{\pm}0.11$, and $0.70{\pm}0.11$, respectively. Conclusion: The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.

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