Comparison of diagnostic values between myocardial perfusion imaging and dual source CT coronary angiography in coronary artery stenosis in patients with diabetes complicated with coronary heart disease

Objective: To evaluate and compare the diagnostic values between myocardial perfusion imaging (MPI) and dual source CT coronary angiography (DS-CTCA) in coronary artery stenosis in the diabetic patients with coronary heart disease (CHD), and to elucidate the clinical application values of MPI combined with DS-CTA in the diabetic patients with CHD. Methods: A total of 52 diabetic patients with CHD underwent the examinations of MPI and DS-CTCA were selected. The degrees of coronary artery stenosis of branches of coronary artery were compared between MPI examination and DS-CTCA examination, including left main coronary artery (LM), left anterior descending coronary artery (LAD), left circumflex branch (LCX) and right coronary artery (RCA). Based on the coronary angiography (CAG)regarded as the golden standard, the specificity, sensitivity and accuracy of each imaging examination method were compared;the specificities, sensitivities and accuracies of parallel diagnosis and serial diagnosis of two kinds of methods were also compared. Results: The stenosis degrees of LM and LAD were no different between MPI examination and DS-CTCA examination (P > 0.05), but the stenosis degrees of LCX and RCA were different between two imaging examination methods (P < 0.05). Compared with MPI examination, the sensitivity of DS-CTCA examination in the diabetic patients with CHD was decreased (71.0% υs 90.1%), and the difference was significant (P = 0.035); the specificity of DS-CTCA examination in the diabetic patients with CHD was increased (85.7% υs 58.4%), and the difference was significant (P = 0.027); but the accuracies of two examinations in the diabetic patients with CHD were no different (76.4% υs 78.4%) (P = 0.062). Compared with parallel diagnosis, the specificity and accuracy of serial diagnosis were increased (93.5% υs 33.8%, P = 0.001; 94.7% υs 71.2%, P = 0.030); but the sensitivities had no difference (95.4% υs 93.1%, P = 0.074). Conclusion: The diagnostic accuracy of evaluating the degree of coronary artery stenosis in the diabetic patients with CHD is not different between DS-CTCA examination and MPI examination. And the serial diagnosis of two examination methods can improve the diagnostic accuracy. (authors)