Myocardial Perfusion Imaging Using Adenosine Triphosphate Stress Multi-Slice Spiral Computed Tomography : Alternative to Stress Myocardial Perfusion Scintigraphy

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Background The present study was designed to : (i) detect myocardial ischemia in contrast enhanced multislice spiral computed tomography (CE-MSCT) using adenosine triphosphate (ATP) pharmacological stress test ; and (ii) evaluate the potential of ATP stress CE-MSCT in a clinical setting. Methods and Results Twelve patients underwent ATP stress CE-MSCT and stress thallium-201 myocardial perfusion scintigraphy (MPS) and 9 of the patients received conventional coronary angiography (CAG). Dual CE-MSCT scans were performed for stress and rest images, with and without intravenous infusion of ATP (0.16mg・kg^<-1>・min^<-1>) at intervals of 20min. Myocardial perfusion and coronary artery were visually evaluated using MSCT and compared the results obtained from MPS and CAG. Of 36 territories, stress images of CE-MSCT described 26 hypo-perfusion areas and MPS described 22 redistributions. The agreement between MSCT and MPS was 83% (30/36, p<0.05). In 141 coronary artery segments of 9 patients undergoing CAG, rest images of CE-MSCT, which had significantly higher assessability than stress images (89% vs 48%, p<0.05), described 76% (13/17) of culprit coronary stenoses. Conclusions Although CT-angiography should be currently assessed using rest images, ATP stress CE-MSCT can describe both ATP-induced myocardial ischemia and coronary artery stenoses in patients with coronary artery disease.
社団法人日本循環器学会の論文
2005-04-20