Non-Invasive Diagnostic Workup of Patients With Suspected Stable Angina by Combined Computed Tomography Coronary Angiography and Magnetic Resonance Perfusion Imaging

• Kirschbaum Sharon W.

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

• Nieman Koen

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

• Springeling Tirza

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

• Weustink Annick C.

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

• Ramcharitar Steve

  Department of Cardiology, Erasmus University Medical Center

• Mieghem Carlos van

  Department of Cardiology, Erasmus University Medical Center

• Rossi Alexia

  Department of Radiology, Erasmus University Medical Center

• Duckers Eric

  Department of Cardiology, Erasmus University Medical Center

• Serruys Patrick W.

  Department of Cardiology, Erasmus University Medical Center

• Boersma Eric

  Department of Cardiology, Erasmus University Medical Center

• de Feyter Pim J.

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

• van Geuns Robert-Jan M.

  Department of Cardiology, Erasmus University Medical Center Department of Radiology, Erasmus University Medical Center

抄録

Background: To evaluate additional adenosine magnetic resonance perfusion (MRP) imaging in the diagnostic workup of patients with suspected stable angina with computed tomography coronary angiography (CTCA) as first-line diagnostic modality. Methods and Results: Two hundred and thirty symptomatic patients (male, 52%; age, 56 year) with suspected stable angina underwent CTCA. In patients with a stenosis of >50% as visually assessed, MRP was performed and the quantitative myocardial perfusion reserve index (MPRI) was calculated. Coronary flow reserve (CFR) using invasive coronary flow measurements served as the standard of reference. CTCA showed non-significant CAD in 151/230 (66%) patients and significant CAD in 79/230 patients (34%), of whom 50 subsequently underwent MRP and CFR. MRP showed reduced perfusion in 32 patients (64%), which was confirmed by CFR in 27 (84%). All 18 cases of normal MRP (36%) were confirmed by CFR. The positive likelihood ratio of MRP for the presence of functional significant disease in patients with a lesion on CTCA was 4.49 (95% confidence interval [CI] 2.12-9.99). The negative likelihood ratio was 0.05 (95%CI 0.01-0.34). Conclusions: CTCA as first-line diagnostic modality excluded coronary artery disease in a high percentage of patients referred for diagnostic workup of suspected stable angina. MRP made a significant contribution to the detection of functional significant lesions in patients with a positive CTCA. (Circ J 2011; 75: 1678-1684)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 75 (7), 1678-1684, 2011

  一般社団法人 日本循環器学会

キーワード

• Computed tomography
• Coronary angiography
• Coronary artery disease
• Coronary flow reserve
• Magnetic resonance imaging

詳細情報

• CRID: 1390282680080498560
• NII論文ID: 10029126713
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-10-1154
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/75/7/75_CJ-10-1154/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2012001397
• 本文言語コード: en
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