Abstract
adenosine 99mTc-sestamibi singlephoton emission computed tomography (SPECT) due to suspected coronary artery disease. All patients underwent power modulation high resolution grey scale RTP imaging with contrast inlusion (Sonovue®), before and during adenosine stress, in conjunction with injection ol the isotope preceding the image acquisition. Apical two- and lour-chamber images were collected. The local zone was first placed close to the base ol the LV, and then in the apical part ol the LV. Analysis of myocardial perlusion was perlormed og-line on a later occasion, blinded lor the SPECT result and the result of the alternative focus position at CSE. Padusion was visually interpreted, comparing rest and hyperaemia images. SPECT images were used as gold standard, and were interpreted according to the clinical routine. Results: SPECT analysis showed apical ischemia in 6 ol 30 patients. Apical local zone positioning significantly (P=0.031) more accurately detected apical ischemia, compared to basal local zone positioning: accuracy, 77 vs 50%; negative predictive value, 87 vs 80%; number of false positive pedusion delects, 4 (13%) vs 15 (50%). Conclusions: Using SPECT as gold standard, RTP-ASE with apical focal zone positioning more accurately detected apical pedusion delects compared to basal focal zone positioning. We recommend apical focal zone positioning lor assessment of apical pedusion defects by RTP-ASE.
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