Abstract
Objective: The aim of the study was the comparison the severity of perfusion abnormalities and the severity
of coronary atherosclerosis in patients with established coronary heart disease based on data analysis of
hybrid positron emission tomography with 13N-ammonia (ammonium-PET) and computed tomography of
the heart multidetector with noninvasive coronary angiography (CT-CA).
Materials and methods. 14 patients (13 men) aged 44 to 80 years (62,6 ± 9,8) underwent MDCT-CA, according
to the standard protocol, and ammonium-PET stress-rest study on a hybrid scanner Biograph-64. In the
hospital all patients received invasive coronary angiography (Rg-CA), which is accepted as the "gold standard".
A total of 42 coronary artery segments were taken for consideration. The hybrid imaging (MDCT-CA + ammonium-
PET) and MDCT-CA results were compared with the Rg-CA. Stenosis >75% was considered as significant
lesion artery for invasive and non-invasive coronary angiography. The result of the hybrid technology
is considered positive if significant changes was detected by at least one of the non-invasive methods.
Results. According to MDCT-CA stenosis in 12/17 arteries were properly verified revealed by coronary angiography.
In the group of arteries with insignificant changes according to coronary angiography coincidence
of the results indicated in 21/24 cases, one artery were excluded from the analysis due to the presence of artifacts.
Stenotic segments with the presence and absence of stress-induced perfusion defects (PD) were analyzed
more details. According to PET DP were noted in 1/10 of the arteries in group with stenosis <50%, in
the l5/16 arteries in the group CA with stenosis 50-74%, in 9/15 arteries in the group with stenosis >75%.
According to hybrid analysis the presence of significant stenoses were confirmed in 6/14 patients. Confirmed
the absence of significant lesions in 3/14 patients with borderline stenosis. The initial view of the hemodynamic
relevance of a stenosis, compiled only on the basis of its size, have changed in 5/14 patients.
Conclusions. Hybrid studies have shown that in patients with multivessel coronary disease probability of
stress-induced ischemia in areas of intact CA (stenosis <50%) is very low, incidences of ischemia increase to
1/3 cases with moderate atherosclerose (stenosis 50-74%), and to 2/3 cases in group arteries with stenosis
up to 75%. Hybrid research allowed to change the perception of the hemodynamic relevance of a stenosis in
37% (5) of patients.
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