Article Figures & Data
Figures
- FIGURE 1.
Three-dimensional reconstruction of multislice spiral CT scan showing coronary artery tree and shape of heart, superimposed by color-coded qualitative stress perfusion image obtained by PET. Ammonia has been used as perfusion tracer; red indicates normal stress perfusion response in anterior and lateral segments of left ventricle.
- FIGURE 2.
(A) Contrast-enhanced CT angiogram showing stenotic lesion in left circumflex coronary artery with faint poststenotic flow (arrow). (B) Coronary angiogram showing same stenotic lesion (arrow). (C) Combined 3-dimensional reconstruction of multislice spiral CT scan showing coronary artery tree and shape of heart, superimposed by color-coded qualitative stress perfusion image obtained by PET. Blue indicates reversible perfusion defect (i.e., ischemia). Lesion described in A and B is hemodynamically relevant, as documented by reduced hyperemic response to adenosine stress in lateral wall (arrowheads).
- FIGURE 3.
Overview of morphologic findings (angiography and CT) and functional findings (PET). For all territories subtended by normal or stenotic coronary vessels, categoric information on ischemia as assessed by PET is given.
- FIGURE 4.
Diagnostic algorithm for clinical decision making. Only the combination of angiographically significant stenosis and evidence of ischemia (by PET) led the decision toward revascularization. Angio = angiography.
- FIGURE 5.
Clinical decision making according to findings of PET plus angiography (Angio) represents gold standard. Decisions made according to PET/CT findings were compared with gold standard. NPV = negative predictive value; PPV = positive predictive value.
Tables
- TABLE 1
Comparison of Contrast-Enhanced CTA Findings with CT Findings and Stress Perfusion Defects
PET CT Coronary angiography LMC LAD LCX RCA Bypass Total <50% ≥50% <50% ≥50% <50% ≥50% <50% ≥50% Patent Stenotic <50% ≥50% All Ischemic ≥50% 0 1 1 3 1 2 0 2 0 1 2 9 11 Normal <50% 18 0 8 2 8 0 11 1 11 0 56 3 59 Normal ≥50% 4 0 2 4 5 2 2 1 0 0 13 7 20 Ischemic <50% 2 0 0 0 0 1 0 0 0 0 2 1 3 Total 24 1 11 9 14 5 13 4 11 1 73 20 93 LMC, LAD, LCX, and RCA = left main, left anterior descending, left circumflex, and right coronary arteries, respectively.
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