Incremental Values of Tl-201 Myocardial Single Photon Emission Computed Tomography and Contrast-Enhanced Multi-Detector Computed Tomography in Patients with Myocardial Infarction

Abstract

Background: With the improvement of the temporal resolution and the electrocardiogram-gating technique, contrast-enhanced multi-detector computed tomography (CE-MDCT) could provide information about myocardial perfusion. The purpose of this study is to compare the detection rate of infarct zone on Tl-201 myocardial single photon emission computed tomography (SPECT) and CE-MDCT and evaluate the value of Tl-20l myocardial SPECT in patients with prior myocardial infarction (MI).Methods: Twenty-four patients with documented history of MI were compared fur myocardial defects and severity between redistribution image of Tl-201 myocardial SPECT and CE-MDCT using two-tailed McNemar's test. The sensitivity, specificity and accuracy of Tl-201 myocardial SPECT for evaluation post-MI ischemia were calculated based on coronary angiography and or clinical follow-up.Results: Myocardial defects were detected in 20 patients (29 territories and 105 segments) with Tl-201 myocardial SPECT, and 22 patients (40 territories and 123 segments) with CE-MDCT (agreement: 0.833 for patients, 0.736 for territories and 0.781 for segments, McNemar's test: P＜0.05 for territories). The severity of myocardial defects was analyzed in the 72 segments with both positive Tl-20l myocardial SPECT and CE-MDCT, which showed fair correlation (agreement 0.625). The sensitivity, specificity and accuracy of Tl-201 myocardial SPECT for detecting post-MI ischemia were 85.7%, 88.2% and 87.5%, respectively.Conclusion: CE-MDCT makes different approach to detect the region of infarcted myocardium as compared with Tl-201 myocardial SPECT. Tl-201 myocardial SPECT is able to detect ischemic myocardial abnormalities, and could provide an incremental value in the further evaluation of patients with MI.