Abstract

INTRODUCTION

The aim of this study is to compare the findings of Tc-99m MIBI MPS and cardiac F-18 FDG PET with invasive coronary angiography (ICA) and to investigate the value of nuclear cardiac methods in the diagnosis of coronary artery disease (CAD).

METHODS

Seventeen patients who had irreversible defect in Tc-99m MIBI MPS and who were referred to our department for viability evaluation with FDG PET were included in the study. All patients had ICA results. The evaluation was performed on a segmental basis and left ventricular myocardial walls were divided into 5 segments: apex, septum, anterior, lateral and inferior walls. Thus, 85 segments were evaluated in 17 patients. It was accepted that the anterior wall, septum and apex were fed from the LAD, the inferior wall from the RCA, and the lateral wall from the Cx. Nuclear cardiac methods and ICA findings were compared.

RESULTS

Seventeen patients with ECG detected unrecognised myocardial infarction (MI) with a mean age of 59.5 years were included in the study. According to the results of ICA, all patients had CAD with ≥ 50% stenosis. The number of segments that MPS was true positive, true negative, false positive and false negative was 67, 12, 3 and 3, respectively. The sensitivity, specificity and accuracy of MPS were 95.7%, 80% and 92.9%, respectively. Excellent agrrement and high correlation were found between MPS findings and ICA results. When MPS and PET were evaluated together and the segments were grouped; ICA stenosis was significantly lower in segments without perfusion and metabolism defect (normal group) than in segments considered viable or infarct.

DISCUSSION AND CONCLUSION

Tc-99m MIBI MPS and F-18 FDG PET are noninvasive methods having great importance in the evaluation of diagnosis and severity of CAD in the patients with ECG detected unrecognised MI.