Comparative analysis of myocardial perfusion imaging and CT coronary arteriography in diagnosis of patients with suspected coronary artery disease

Objective: The aim of this study was to analyze the relationship between myocardial perfusion imaging (MPI) and computed tomography coronary arteriography (CTCA) in diagnosis of patients with suspected coronary artery disease (CAD). Methods: Forty patients with suspected CAD underwent invasive coronary angiography( CAG), MPI and CTCA within 2 months. The results of myocardial perfusion imaging were classified tis normal or abnormal [reversible and (or) fixed defects]; The CTCA studies were classified as normal, non-obstructive (< 50% stenosis) CAD, or obstructive CAD. Taking the results of CAG as 'gold standard', the findings of MPI and CTCA were comparatively analyzed. Concordant and discordant results between MPI and CTCA were statistically analyzed using Kappa test. P<0.05 was considered statistically significant. Results: About 90.1% patients with normal CTCA also showed normal MPI. However, only 44.8% patients with abnormal CTCA showed corresponding perfusion abnormalities on MPI. Conversely, 61.5% patients with normal MPI had abnormal CTCA. Compared with CAG, the sensitivity, specificity and accuracy of CTCA were 96.4% (27/28), 83.3% (10/12) and 92.5% (37/40), and those of MPI were 46.4% (13/28), 91.7% (11/12) and 60.0% (24/40) respectively. Conclusions: MPI and CTCA provide different but complementary information in diagnosis of patients with suspected CAD. Their clinical value and application should be practically combined. (authors)