title: Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging.
abstract: OBJECTIVE
  The aim of this study was to perform a head-to-head comparison between multi-slice computed tomography (MSCT) and myocardial perfusion imaging (MPI) in patients with an intermediate likelihood of coronary artery disease (CAD) and to compare non-invasive findings to invasive coronary angiography.
  
  
  BACKGROUND
  Multi-slice computed tomography detects atherosclerosis, whereas MPI detects ischemia; how these 2 techniques compare in patients with an intermediate likelihood of CAD is unknown.
  
  
  METHODS
  A total of 114 patients, mainly with intermediate likelihood of CAD, underwent both MSCT and MPI. The MSCT studies were classified as having no CAD, nonobstructive (<50% luminal narrowing) CAD, or obstructive CAD. Myocardial perfusion imaging examinations were classified as showing normal or abnormal (reversible and/or fixed defects). In a subset of 58 patients, invasive coronary angiography was performed.
  
  
  RESULTS
  On the basis of the MSCT data, 41 patients (36%) were classified as having no CAD, of whom 90% had normal MPI. A total of 33 patients (29%) showed non-obstructive CAD, whereas at least 1 significant (> or =50% luminal narrowing) lesion was observed in the remaining 40 patients (35%). Only 45% of patients with an abnormal MSCT had abnormal MPI; even in patients with obstructive CAD on MSCT, 50% still had a normal MPI. In the subset of patients undergoing invasive angiography, the agreement with MSCT was excellent (90%).
  
  
  CONCLUSIONS
  Myocardial perfusion imaging and MSCT provide different and complementary information on CAD, namely, detection of atherosclerosis versus detection of ischemia. As compared to invasive angiography, MSCT has a high accuracy for detecting CAD in patients with an intermediate likelihood of CAD.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Douwe E
authors.initials: DE
authors.lastname: Atsma
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Marcel P M
authors.initials: MP
authors.lastname: Stokkel
authors.forename: Petra
authors.initials: P
authors.lastname: Dibbets-Schneider
authors.forename: Isabel
authors.initials: I
authors.lastname: Decramer
authors.forename: Pieter
authors.initials: P
authors.lastname: De Bondt
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Piet K
authors.initials: PK
authors.lastname: Vanhoenacker
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed