title: A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest.
abstract: BACKGROUND
  Although computed tomography coronary angiography (CTCA) can identify coronary stenosis, little data exists on the ability of multislice computed tomography (MSCT) to detect myocardial perfusion defects at rest.
  
  
  METHODS
  In 33 patients with diagnosed or suspected coronary artery disease (CAD), CTCA using retrospective electrocardiography (ECG) gating at rest and invasive coronary angiography (ICA) was performed. The 2D myocardial images were reconstructed in diastolic and systolic phases using the same raw data for CTCA. CT values of the myocardium were used as an estimate of myocardial enhancement, which were shown by color mapping. Myocardial ischemia was defined as a pattern of transient endocardial hypo-enhancement at systole and normal enhancement at diastole. The results of ICA were taken as the reference standard.
  
  
  RESULTS
  When a diameter reduction of more than 50% in ICA was used as diagnostic criteria of CAD, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT first-pass myocardial perfusion imaging (MPI) at rest were 0.85, 0.67, 0.92, and 0.50 per patient, respectively, and 0.58, 0.93, 0.85, and 0.76 per vessel, respectively.
  
  
  CONCLUSIONS
  CT first-pass MPI at rest could detect CAD patients, which could become a practical and convenient way to detect ischemia, consequently offering the ability for MSCT to act as a "one stop shop" for the diagnosis of CAD.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Qin
authors.forename: Lu-yue
authors.initials: LY
authors.lastname: Gai
authors.forename: Yun-dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Dong
authors.forename: Zhi-wei
authors.initials: ZW
authors.lastname: Guan
authors.forename: Zhi-guo
authors.initials: ZG
authors.lastname: Wang
authors.forename: Zhi-jun
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Jia-he
authors.initials: JH
authors.lastname: Tian
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010865:Pilot Projects; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*