Comparison of stress perfusion MRI and SPECT for detection of myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease.
OBJECTIVE
This study aims to evaluate the diagnostic value of stress perfusion MRI and SPECT for the detection of myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease.


METHODS
We retrospectively enrolled 78 patients with angiographically proven three-vessel coronary artery disease who underwent both stress perfusion MRI and SPECT within 4 weeks of each other. Image analysis was performed to compare the diagnostic value of stress perfusion MRI with that of SPECT; coronary angiography was used as the reference standard. The statistical significance of the difference between stress perfusion MRI and SPECT was evaluated by use of the paired McNemar test.


RESULTS
Myocardial ischemia was detected significantly more often by stress perfusion MRI than by SPECT, with more abnormal segments (mean +/- SD, 10.1 +/- 3.6 vs 4.9 +/- 2.6; p < 0.001) and abnormal vascular territories (2.55 +/- 0.5 vs 1.64 +/- 0.7; p < 0.001) identified per patient. The overall sensitivity for identifying perfusion defects in three vascular territories was higher for stress perfusion MRI than for SPECT (84.6% vs 55.1%; p < 0.001). The sensitivity of stress perfusion MRI and SPECT for detecting any perfusion defect per patient was 100% and 96.2%, respectively. However, perfusion defects in all three vascular territories were detected in 57.7% of patients by stress perfusion MRI but in only 11.5% of patients by SPECT.


CONCLUSIONS
Stress perfusion MRI is superior to SPECT for detecting myocardial ischemia in patients with angiographically proven three-vessel coronary artery disease.
Chung
Se-Yeong
SY
Department of Radiology, Seoul National University, Boramae Medical Center, Republic of Korea.
Lee
Kang-Young
KY
Chun
Eun Ju
EJ
Lee
Won-Woo
WW
Park
Eun Kyung
EK
Chang
Hyuk-Jae
HJ
Choi
Sang Il
SI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*