Roque Oca MD, Presenter: Nothing to Disclose

Carlos Delgado MD, Abstract Co-Author: Nothing to Disclose

Carmen Trinidad MD, Abstract Co-Author: Nothing to Disclose

Ana Fernández del Valle MD, Abstract Co-Author: Nothing to Disclose

Gonzalo Tardaguila De La Fuente MD, Abstract Co-Author: Nothing to Disclose

Alex Grande, Abstract Co-Author: Nothing to Disclose

Noelia Silva MD, Abstract Co-Author: Nothing to Disclose

Daniel Castellon PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the accuracy and feasibility of adenosine-induced stress myocardial perfusion and late enhancement images with dual-source CT (DSCT) compared with MRI in patients with clinical suspicion of coronary artery disease (CAD).

Fifty-six patients at clinical suspicion of CAD were prospectively enrolled for evaluation with DSCT and MRI: myocardial perfusion and viability were analized with both techniques. Coronary anatomy was also study with DSCT. All patients underwent this protocol: -1st: Adenosine-induced stress dual energy-CT (DECT): 3´of IV adenosine perfusion (140 ug/Kg/min) for the detection of cardiac perfusion defects. -2nd: 5´ later: Coronariography-CT with high pitch, to evaluate coronary anatomy. -3rd: 7´ later: High pitch and low kV CT in order to assess the viability.   Within 15 days after the CT, MRI was performed with the next protocol to all patients: -Stress perfusion after 3´ of IV adenosine and basal perfusion 10´later. -Viability: 10´after the basal perfusion MRI. All images were analized in consensus by two radiologists. Sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of perfusion and late enhacement cardiac CT were calculated.

39 men and 17 women; mean age: 63 +/- 10 years old. 952 myocardial segments were analyzed. 55 of them showed any kind of perfusion defect, and there were 23 segments wtih late enhancement . Compared with MRI, DSCT presents the following values for sensitivity, specificity, NPV, PPV: Miocardial perfusion defects: 79%, 99%, 89%, 98%, respectively. Late enhancement: 64%, 99%, 82%, 99%, respectively. Mean estimated effective dose for global evaluation DSCT was 8,3 mSv +/- 3 mSv.

In patients with clinical suspicion of CAD myocardial perfusion and viability may be evaluated with DSCT, achieving great accuracy diagnostic values and studying coronary arteries simultaneously with an acceptable radiation dose.  

DSCT may be used as "one stop shop technique" in the evaluation of clinical suspicion of CAD with aceptable radiation doses.

Oca, R, Delgado, C, Trinidad, C, Fernández del Valle, A, Tardaguila De La Fuente, G, Grande, A, Silva, N, Castellon, D, Clinical Suspicion of Coronary Artery Disease: Myocardial Perfusion and Viability DSCT Compared with MRI: Beyond the Anatomy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043437.html