Background and objectives Coronary angiography (CAG) always been regarded the “golden standard” for diagnosis of coronary artery disease (CAD), which was invasive and couldn't provide functional information. Combination of CT coronary angiography (CTCA) and stress myocardial perfusion scintigraphy (MPS) using SPECT could provide both anatomical and functional information non-invasively and accurately. However, the accumulative radiation dose and complex process limit the clinical practice. Taking advantage of the theory of myocardial perfusion changing phasicly, we explored the feasibility and accuracy of contrasted MSCT at rest as “one-stop-shop” for diagnosis of CAD.
Methods 55 patients, suspected or diagnosed as CAD, were performed with CTCA using retrospective ECG gating at rest. CT first-pass myocardial perfusion imaging (CT first-pass MPI) were reconstructed in both diastolic and systolic phases using the same raw date for CTCA. CT numbers of the myocardium were used as an estimate of myocardial enhancement, which were showed by colour map. We defined myocardial ischaemia as a pattern of transient endocardial hypo-enhancement at systole and normal enhancement at diastole.
Results The sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CTCA for diagnosis of CAD were 97.1%, 75.0%, 88.2%, 93.1% and 89.5%, respectively, and compared with 92.3%, 93.8%, 97.3%, 83.3% and 92.7%, respectively, for CT first-pass MPI, which had no significant difference with CTCA.
Conclusions CTCA+CT first-pass MPI could provide both anatomical and functional information of the CAD synchronously and simultaneously without any more radical dosage, contrast agent dosage and any stress process, which may become the new non-invasive “one-stop-shop” for diagnosis of CAD.