Value of calcium scoring in addition to myocardial perfusion imaging in patients with coronary artery disease | ||
| SECI Oncology Journal | ||
| Volume 10, Issue 3, July 2022, Pages 146-151 | ||
| Abstract | ||
| Background: coronary artery disease possible to have existed with little or no signs, or it may quickly develop to an abrupt arterial closure of the artery with catastrophic outcomes and possibly resulting in sudden death as initial presentation. Death rates due to coronary artery disease (CAD) have fallen dramatically over the last 20 years, mostly due to improved diagnosis and treatment of people with known or suspected CAD. Improvements in the assessment of known or suspected CAD individuals beside safe guidance for treatment choices have been made possible by the increasing use of noninvasive imaging methods. And thus, there is a continuous searching for new noninvasive techniques for early detection of CAD. Aim of work: This study aimed to determine the correlation between MPI and CAC scoring in individuals with various CAD risk factors, as well as the diagnostic role for CAC scoring in CAD diagnosis. Patients and Methods: the present study included fifty individuals who were recruited from Nuclear Medicine unit at Kasr Al-Aini Hospital (NEMROK), Cairo University during the period of October 2017 to February 2018. SPECT Tc-99m SestaMIBI myocardial perfusion imaging was performed over the course of two days using the technique ECG-gated SPECT. Bull's-eye display with 17 segments reflecting the whole myocardium was generated. Additional gated high dose CT images were obtained for the estimation of CAC score, the readings of the CAC score were then compared to those of MPI study. Results: The study showed that both MPI defect size and severity are strongly correlated with CAC score with mean CAC score in case of normal MPI 155.6+/-152 and in case of abnormal MPI 1096+/-570.9 and p-value <0.0001. We also found that the more the clinical risk the more the CAC score reading and the more the cases with +ve MPI study, that’s why we recommended that in low clinical risk score we shall start with CAC scoring if it’s found to be discrete or low risk we shouldn’t proceed with MPI study instead we go on with CAC score screening, while if the patient initially is intermediate or high risk we shouldn’t go for CAC scoring instead MPS is the study of choice. Conclusions: There is strong correlation between total CACs and MPI defect size and severity. So at the end of our study we highlighted the following: Total CACs can be used as initial imaging procedure in clinically low risk patients with CAD. MPI study should be the first imaging choice in clinically intermediate or high risk patients with CAD. | ||
| Keywords | ||
| Value; Calcium Scoring; Myocardial; Perfusion Imaging; coronary artery disease | ||
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