Study Of 64-Slice CT And PET In Assessment Of Myocardial Viability

Part 1An experimental animal model of Myocardial ischemic:study of positron emission tomography, single photon emission computed tomography and pathologyObjective To compare ²⁰¹T1 SPECT imaging for the assessment of myocardial viability with ¹⁸F-FDG PET imaging in pigs with chronic myocardial ischemic. Methods 9 animal models completed all examination successfully.²⁰¹T1 SPECT imaging and ¹⁸F-FDG PET imaging were performed on 9 pigs models of chronic myocardial ischemia induced with ameroid constrictors.The viable myocardial segments were determined by hemotoxylin and eosin staining to identify myocardial changes.Results In 81 myocardial segments,The viable myocardial segments which assessed by 18F-FDG PET imaging and 201T1 SPECT imaging were 73(90.1%) and 62(76.5%) respectively.The viable myocardial segments percentages were statistically different within one group(χ2=5.37,P＜0.05).With HE staining,the viable myocardial segments were 74(91.3%).Comparing with 18F-FDG PET imaging and HE staining,The viable myocardial segments percentages were not statistically different within one group(χ²=0.073,P＞0.05).Conclusion Compared with ²⁰¹T1 SPECT imaging,¹⁸F-FDG PET imaging assesses viable myocardial more accurately.Part 2Comparison of 64-Slice CT and PET In Assessment Of Myocardial Viability Of Patients Acute Myocardial InfarctionObjective To evaluate the diagnostic value for myocardial viability by using late-enhancement 64-Slice Computed Tomography compared with ¹⁸F-FDG PET imaging in patients with Acute Myocardial Infarction.Methods Our study population comprised 15 men and 5 women.Mean age was 60±13 years.Myocardial infarction was anterior(n=8),inferior(n= 9),anterior and septal(n = 3).20 patients admitted for a first acute myocardial infarction followed by 64-slice CT and ¹⁸F-FDG PET imaging.And the 17 myocardial segments of the left ventricle depicted by the American Heart Association.In order to determine the agreement of two methods,17 myocardial segments Data were analyzed respectively by McNemar test and Kappa test.Results Analysis of assessment of Myocardial Viability revealed best agreement between 5 myocardial segments(Kappa=1),better agreement between 10 myocardial segments(Kappa＞0.75)and good agreement between 2 myocardial segments (0.40≤Kappa≤0.75 ).Conclusions There was high agreement between two methods.Late-enhancement 64-Slice Computed Tomography is a promising method for assessment of Myocardial Viability.Part 3Comparison of 64-slice Computed Tomography And Conventional Angiography For Detecting Coronary Artery StenosiSObjective The aim of the present study was to evaluate the accuracy and feasibility of 64 slice spiral computed tomography(MSCT)in detecting coronary artery stenoses.Methods 82 patients 68 male,14 female;mean age(60.64±13.47)years with suspected coronary artery disease underwent coronary angiography and 64 slice CT(SOMATOM SENSAT10N CARDIAC64 CT,Siemens,Germany) The mean time span between coronary angiography(CAG) and CTA was 7 days.Evaluation of right coronary artery(RCA),left main(LM),left anterior descending artery(LAD), diagonal branch 1(D1),circumflex branch(CX),and 1st marginal branch was performed by two.All vessels with a diameter≥1.5 mm were analysed and a lumen restriction of≥50%was considered a significant stenosis.Invasive coronary angiography was taken as gold standard for calculations of diagnostic accuracy.Results Of 984 segments,Compared with CAG,the sensitivity of CTA to diagnose significant stenosis was 95.1%,specificity98.53%,positive predictive value(PPV) 88.18%and negative predictive value(NPV) 99.43%.Conclusion Sixty-four MSCT has a high accuracy for the detection of significant coronary artery stenoses and therefore can be considered as a valuable noninvasive technique.