title: Discordance between the morphological and physiological information of 64-slice MSCT coronary angiography and myocardial perfusion imaging in patients with intermediate to high probability of coronary artery disease.
abstract: BACKGROUND
  The aim of this study was to determine the relationship between the morphological and physiological information of coronary CT angiography (CCTA) and stress myocardial perfusion imaging (S-MPI) from the standpoint of risk stratification of patients with intermediate to high probability of coronary artery disease (CAD).
  
  
  RESULTS
  In total, 51 patients underwent both CCTA and S-MPI as sequential examinations. In each patient, the severity of coronary plaque and stenosis (>50%) and the presence of myocardial perfusion abnormalities were assessed and the prognostic information from the CCTA and S-MPI results was compared. In 30 patients with normal S-MPI, 3 (10%) had only completely normal coronaries and another 3 (10%) had non-obstructive CAD as observed on CCTA. The remaining 24 patients (80%) with normal S-MPI and all 21 patients with abnormal S-MPI study had obstructive CAD. High-risk CAD (defined as obstructive left main trunk (LMT) lesion or 3-vessel disease) was seen in 10 (33%) of 30 patients with normal S-MPI, although it was less frequent than in the 14 (67%) of 21 patients with abnormal S-MPI.
  
  
  CONCLUSIONS
  A normal S-MPI result can reflect a wide range of coronary atherosclerosis types and severities and, to some extent, involves severe coronary atherosclerosis such as LMT lesion and 3-vessel disease in patients with an intermediate to high probability of CAD.
authors.affiliation: Department of Radiology, Graduate School of Radiology, Nippon Medical School, Japan. tomonarikiriyama@hotmail.com
authors.forename: Tomonari
authors.initials: T
authors.lastname: Kiriyama
authors.forename: Masahiro
authors.initials: M
authors.lastname: Toba
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takano
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Kumita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed