Coronary Artery Disease: Analysis of Diagnostic Performance of CT Perfusion and MR Perfusion Imaging in Comparison with Quantitative Coronary Angiography and SPECT-Multicenter Prospective Trial.
Coronary Artery Disease: Analysis of Diagnostic Performance of CT Perfusion and MR Perfusion Imaging in Comparison with Quantitative Coronary Angiography and SPECT-Multicenter Prospective Trial.
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DOI：
10.1148/radiol.2017162447
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发表时间：
2017-09
期刊：
影响因子：
19.7
通讯作者：
M. Rief;Marcus Y. Chen;A. Vavere;Benjamin Kendziora;Julie M. Miller;W. Bandettini;Christopher Cox;R. George;J. Lima;M. D. Di Carli;M. Plotkin;E. Zimmermann;M. Laule;P. Schlattmann;Andrew E. Arai;M. Dewey
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作者：
M. Rief;Marcus Y. Chen;A. Vavere;Benjamin Kendziora;Julie M. Miller;W. Bandettini;Christopher Cox;R. George;J. Lima;M. D. Di Carli;M. Plotkin;E. Zimmermann;M. Laule;P. Schlattmann;Andrew E. Arai;M. Dewey
目的比较负荷心肌CT灌注成像（CT）和负荷心肌MR灌注成像（MR）对冠心病（CAD）的诊断价值。材料和方法所有患者在纳入本机构审查委员会批准的研究之前给予书面知情同意书。这项前瞻性联合无创冠状动脉造影和心肌灌注成像（使用320排探测器计算机断层扫描（CORE 320））多中心试验的双中心子研究纳入了92例患者（平均年龄，63.1岁± 8.1岁[标准差]; 73%为男性）。所有患者均接受了腺苷或regadenoson负荷的灌注CT和灌注MR成像。预定义的参考标准是定量冠状动脉造影（QCA）和单光子发射CT（SPECT）的组合或单独的QCA。冠状动脉CT血管造影的结果不包括在内，诊断性能通过疾病状态分层的Mantel-Haenszel检验进行评价。结果92例患者中，单用QCA和SPECT诊断的冠心病患病率为39%（36/92），单用QCA诊断的冠心病患病率为64%（59/92）。与QCA和SPECT相比，灌注CT和灌注MR成像的诊断准确率为63%（58/92）和75%（69/92）（P = .11）;灵敏度为92%特异性分别为45%（25/56）和70%（39/56）（P <0.01）。与单纯QCA相比，CT灌注成像和MR灌注成像的诊断准确率为82%（75/92）和74%（68/92）（P = 0.27）;灵敏度为90%特异性分别为67%（22/33）和82%（27/33）（P = 0.27）。结论CT灌注成像与MR灌注成像对冠心病的诊断价值相似。© RSNA，2017在线补充材料可用于本文。
Purpose To compare the diagnostic performance of stress myocardial computed tomography (CT) perfusion with that of stress myocardial magnetic resonance (MR) perfusion imaging in the detection of coronary artery disease (CAD). Materials and Methods All patients gave written informed consent prior to inclusion in this institutional review board-approved study. This two-center substudy of the prospective Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) multicenter trial included 92 patients (mean age, 63.1 years ± 8.1 [standard deviation]; 73% male). All patients underwent perfusion CT and perfusion MR imaging with either adenosine or regadenoson stress. The predefined reference standards were combined quantitative coronary angiography (QCA) and single-photon emission CT (SPECT) or QCA alone. Results from coronary CT angiography were not included, and diagnostic performance was evaluated with the Mantel-Haenszel test stratified by disease status. Results The prevalence of CAD was 39% (36 of 92) according to QCA and SPECT and 64% (59 of 92) according to QCA alone. When compared with QCA and SPECT, per-patient diagnostic accuracy of perfusion CT and perfusion MR imaging was 63% (58 of 92) and 75% (69 of 92), respectively (P = .11); sensitivity was 92% (33 of 36) and 83% (30 of 36), respectively (P = .45); and specificity was 45% (25 of 56) and 70% (39 of 56), respectively (P < .01). When compared with QCA alone, diagnostic accuracy of CT perfusion and MR perfusion imaging was 82% (75 of 92) and 74% (68 of 92), respectively (P = .27); sensitivity was 90% (53 of 59) and 69% (41 of 59), respectively (P < .01); and specificity was 67% (22 of 33) and 82% (27 of 33), respectively (P = .27). Conclusion This multicenter study shows that the diagnostic performance of perfusion CT is similar to that of perfusion MR imaging in the detection of CAD. © RSNA, 2017 Online supplemental material is available for this article.