[The value of dipyridamole-technetium-99m carbomethoxyisopropylisonitrile (CPI) myocardial tomography imaging in diagnosing coronary artery disease].
Fifty cases of clinically proven or suspected coronary artery disease (CAD) underwent dipyridamole-technetium-99m CPI (DP-99mTc. CPI) myocardial tomography imaging and coronary angiography. All cases with angiographically proven CAD had positive DP-99 mTc. CPI. The sensitivity was 100%. Six of 13 cases with normal coronary arteriogram showed false positive results (3 cases of hypertrophic cardiomyopathy and 3 cases of chest pain with unknown causes). Therefore, the specificity was 53.8% (7/13). The positive predictive accuracy of DP-99m Tc. CPI myocardial imaging was 88.0%. However, We do not consider it justified to apply this statistics to general population as our patients were highly selected. One hundred and twelve myocardial segments of left ventricle were shown to be infarcted or ischemic by either radionuclear imaging or ECG. In 108 segments with abnormal images, only 10 in patients with hypertrophic cardiomyopathy had normal coronary artery supply. Therefore, the reliability of DP-99 mTc. CPI myocardial imaging to display infarcted or ischemic segments was 91.0% (102/112). The ability for 99mTc. CPI imaging to differentiate between infarcted and ischemic lesions was somewhat indefinite, especially in case of localized infarction. The reason of this shortcoming was discussed. Ninety segments were shown to be infarcted or ischemic by ECG, 4 of which had no corresponding coronary artery stenosis. However, in 12 of the 22 segments with normal ECG pattern the corresponding coronary arteries were either occluded or stenosed, resulting in 54.5% (12/22) false negativity. Most of these false negatives were found in posterior and septal walls. Angina pectoris after dipyridamole infusion occurred in 4 of our 50 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Wang
S
S
General Hospital, PLA, Beijing.
D000328:Adult; D004176:Dipyridamole; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D009570:Nitriles; D015609:Organotechnetium Compounds; D015899:Tomography, Emission-Computed, Single-Photon
D009570:Nitriles; D015609:Organotechnetium Compounds; C051216:technetium Tc 99m carbomethoxyisopropylisonitrile; D004176:Dipyridamole