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Complementary role of computed tomography angiography with fixed perfusion defects on SPECT myocardial perfusion imaging. 2022

Rami M Abazid, and Yasmine T Sallam, and Jonathan G Romsa, and James C Warrington, and Cigdem Akincioglu, and Sabe De, and Nikolaos Tzemos, and William C Vezina
Division of Nuclear Medicine, Section of Cardiac Hybrid Imaging, Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada. ramiabazid@yahoo.com.

OBJECTIVE We present this case series exploring the complementary role of coronary computed tomography angiography (CCTA) to SPECT myocardial perfusion imaging (MPI) in the detection of myocardial necrosis. METHODS A cardiac hybrid imaging database search identified 144 patients with a previous history of ST-segment elevation myocardial infarction treated with coronary revascularization. CCTA and MPI scans were evaluated to determine whether CCTA had an added value to MPI in detecting myocardial necrosis. RESULTS Five patients with patent stents and/or bypass grafts and both fixed perfusion defects on MPI and sub-endocardial hypo-perfusion on CCTA were identified. The extent and location of the perfusion defects were closely correlated between the CCTA and SPECT MPI images. CONCLUSIONS In this series, CCTA and SPECT MPI were found to play a complementary role in the assessment of fixed perfusion defect, with CCTA adding specificity to the diagnosis of myocardial necrosis.

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