Evaluation of coronary artery disease extent using 99Tcm-sestamibi: comparison of dipyridamole versus exercise and of planar versus tomographic imaging.
The aim of this study was to compare the reliability of 99Tcm-sestamibi myocardial scintigraphy for the assessment of coronary artery disease extent using two different stresses (exercise and dipyridamole) and imaging techniques (planar versus single photon emission tomography, SPET) in a patient population of 20 subjects, all also studied with coronary angiography. The agreement of exercise and dipyridamole was good for the visual uptake score (planar kappa = 0.71, SPET kappa = 0.64) and for abnormal segment detection (planar and SPET both kappa = 0.76). For the recognition of the individual diseased vessel, the results of exercise and dipyridamole planar scans were equal (sensitivity 49%, specificity 90%, accuracy 63%); those of exercise and dipyridamole SPET were also similar and were both better than the related planar data (sensitivity 79% and 74%, P < 0.005 and < 0.02, respectively, versus planar; specificity 95% and 100%; accuracy 85 and 83%, P < 0.001 and < 0.02 versus planar). Both stresses and imaging techniques were less sensitive in cases of mild (50 to 70%) obstructions. In conclusion, exercise and dipyridamole appear equally effective stresses for 99Tcm-sestamibi scintigraphy; with both of them, however, SPET allows significantly better results than planar imaging and therefore should be recommended.
Bisi
G
G
Department of Clinical Pathophysiology, University of Florence, Italy.
Sciagra
R
R
Santoro
G M
GM
Briganti
V
V
Leoncini
M
M
Fazzini
P F
PF
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D004176:Dipyridamole; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi
D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi