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Noninvasive stress testing of myocardial perfusion defects: head-to-head comparison of thallium-201 SPECT to MRI perfusion

Vincenti, Gabriella
Steiner, Charles
Imperiano, Hestia
Ambrosio, Giuseppe
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Published in Journal of Nuclear Cardiology. 2009, vol. 16, no. 4, p. 549-561
Collection Open Access - Licence nationale Springer
Abstract BACKGROUND: To evaluate the diagnostic value of magnetic resonance imaging (MRI) of myocardial perfusion in the assessment of flow-limiting epicardial stenosis in a head-to-head comparison with abnormal thallium-201 ((201)TI) single photon emission tomography (SPECT) studies in patients with predominantly known coronary artery disease (CAD). METHODS AND RESULTS: Twenty-one patients (mean age 65 +/- 10 years) with reversible myocardial perfusion defects on (201)TI-SPECT images during dipyridamole-stimulated hyperemia were recruited for study purpose. Within 5 days of the (201)TI-SPECT study, myocardial perfusion was studied again with MRI during dipyridamole stimulation and at rest. Overall, (201)TI-SPECT identified 30 reversible regional perfusion defects. The sensitivity to detect hypoperfused segments was 70% (21/30) with the GRE-MRI perfusion analysis with (201)TI-SPECT as reference. When patients were subgrouped according to the extent of regional reversible perfusion defects on (201)TI-SPECT, mild- (SDS: 2-4), moderate- (SDS: 5-8), and severe- (SDS > 8) perfusion defects were also identified by GRE-MRI perfusion analysis in 75% (6/8), in 56% (9/16) and 100% (6/6), respectively. CONCLUSIONS: GRE-MRI first-pass stress perfusion imaging may not identify up to 30% of mild-to-moderate perfusion defects in a group of preselected patients with predominantly known CAD and abnormal (201)TI-SPECT studies.
Keywords AdultAgedAngina Pectoris/diagnosis/radionuclide imagingCoronary Angiography/methodsCoronary Artery Disease/diagnosis/radionuclide imagingFemaleHumansMagnetic Resonance Imaging/*methodsMaleMiddle AgedMyocardial Ischemia/pathologyMyocardial Perfusion Imaging/*methodsPerfusionThallium Radioisotopes/*diagnostic useTomography, Emission-Computed, Single-Photon/*methods
PMID: 19488826
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Research groups Biologie du myocarde (22)
L'athérosclérose et ses complications cliniques (591)
Groupe Ratib Osman (nouvelles techniques d'imagerie moléculaire) (819)
Groupe Schindler Thomas (cardiologie) (890)
Imagerie cardiaque fonctionnelle (541)
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VINCENTI, Gabriella et al. Noninvasive stress testing of myocardial perfusion defects: head-to-head comparison of thallium-201 SPECT to MRI perfusion. In: Journal of Nuclear Cardiology, 2009, vol. 16, n° 4, p. 549-561. doi: 10.1007/s12350-009-9097-6 https://archive-ouverte.unige.ch/unige:20156

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Deposited on : 2012-04-23

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