Diagnostic accuracy of single photon emission computed tomography with thallium-201 for the identification of diseased coronary arteries. Comparison between dipyridamole infusion and exercise stress test.
Myocardial perfusion imaging with 201Tl and single-photon emission computed tomography (SPECT) was carried out in two groups of patients, subsequently submitted to diagnostic coronary angiography. SPECT was performed in group 1 (41 patients) after slow i.v. infusion of dipyridamole and in group 2 (162 patients) after tracer injection at maximal ergometric exercise. To evaluate the diagnostic capability of SPECT in the detection of diseased coronary vessels, the left ventricular myocardium was subdivided into 6 segments related to the three major coronary arteries. Sensitivity for the left anterior descending artery was 77% in group 1 and 79% in group 2; specificity was 80% and 96%, respectively. Sensitivity for the right coronary artery was 91% in group 1 and 85% in group 2; specificity was 81% and 73%. For the left circumflex artery sensitivity was 65% for group 1 and 67% for group 2, while specificity was 89% and 88%, respectively. Myocardial SPECT results after ergometric exercise and dipyridamole infusion turned out to be almost superimposable. Dipyridamole stress might be considered appropriate as a provocative test when physical exercise cannot be carried out.
Dondi
M
M
Department of Nuclear Medicine, S. Orsola-Malpighi Policlinic Hospital, Bologna, Italy.
Monetti
N
N
Levorato
M
M
Corbelli
C
C
Zagni
P
P
Tartagni
F
F
Maiello
L
L
Fallani
F
F
Ortolani
P
P
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes; D004176:Dipyridamole