Abstract
PurposeWe 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.MethodsA 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.ResultsFive 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.ConclusionIn 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.
Highlights
Fixed perfusion defect (FPD) is a perfusion abnormality that is detected on both rest and stress single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) scans of the identical location, size and severity (Garcia et al 2020; Busch et al 2011)
Fixed perfusion defect (FPD) is a perfusion abnormality that is detected on both rest and stress SPECT MPI scans of the identical location, size and severity (Garcia et al 2020; Busch et al 2011)
We report five patients with both FPD on SPECT-MPI scans and hypoenhancement on coronary computed tomography angiography (CCTA) scans, Figs. 1, 2, 3, 4 and 5
Summary
Fixed perfusion defect (FPD) is a perfusion abnormality that is detected on both rest and stress SPECT MPI scans of the identical location, size and severity (Garcia et al 2020; Busch et al 2011). Abazid et al European Journal of Hybrid Imaging (2022) 6:3 perfusion with late-phase CT imaging (delay enhancement) in the detection of myocardial scar. No definite criteria exist to identify non-viable myocardium with coronary computed tomography angiography (CCTA) without using the delay enhancement scan (Garcia et al 2020; Busch et al 2011). The purpose of this analysis is to explore whether CCTA has added value to SPECT MPI in diagnosing nonviable myocardium
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