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Myocardial positron computed tomography with 13N-ammonia at rest and during exercise

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Abstract

To assess the value of myocardial-perfusion positron computed tomography (PCT) for the evaluation of coronary artery disease (CAD), 13N-ammonia PCT using a whole-body multislice PCT device was performed at rest and during exercise in 6 normal subjects and 19 patients with angiographically documented CAD. The 13N-ammonia distribution in the myocardium was assessed both qualitatively and quantitatively. At rest and during exercise, the tracer distribution was homogeneous in the 6 normal cases. In the 19 patients with CAD, regional hypoperfusion was observed in 14 cases (74%) at rest and in 18 cases (95%) during exercise. Additional perfusion abnormalities were detecting during exercise in 12 cases. Segmental analysis of the myocardial perfusion identified 30 out of 34 stenosed vessels (88%) during exercise, with only one false-positive finding of diseased vessels (specificity, 98%). For the quantitative analysis of myocardial perfusion by PCT, the percentage of change in the tracer concentration in the same region between the rest and stress images was calculated. The concentration was slightly increased in normal myocardial segments (14.4%±5.8%; P<0.001), whereas in CAD, it was significantly decreased in segments with stenosed vesels (-18.0%±18.3%; P<0.02). We conclude that 13N-ammonia PCT at rest and during exercise provides highquality images, and is a sensitive and effective technique for detecting CAD and identifying individual stenosed vessels. Furthermore, this technique makes possible quantitative assessment of the coronary reserve function.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Kyoto University School of Medicine, Shogoin, 606, Sakyo-ku, Kyoto, Japan

    Nagara Tamaki M.D., Yoshiharu Yonekura, Michio Senda, Shehbaz A. Kureshi, Hideo Saji, Shusei Kodama & Kanji Torizuka

  2. Department of Cardiovascular Surgery, Kyoto University School of Medicine, Shogoin, 606, Sakyo-ku, Kyoto, Japan

    Yutaka Konishi & Toshihiko Ban

  3. Department of Internal Medicine, Kyoto University School of Medicine, Shogoin, 606, Sakyo-ku, Kyoto, Japan

    Hirofumi Kambara & Chuichi Kawai

Authors
  1. Nagara Tamaki M.D.
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  2. Yoshiharu Yonekura
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  3. Michio Senda
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  4. Shehbaz A. Kureshi
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  5. Hideo Saji
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  6. Shusei Kodama
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  7. Yutaka Konishi
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  8. Toshihiko Ban
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  9. Hirofumi Kambara
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  10. Chuichi Kawai
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  11. Kanji Torizuka
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Tamaki, N., Yonekura, Y., Senda, M. et al. Myocardial positron computed tomography with 13N-ammonia at rest and during exercise. Eur J Nucl Med 11, 246–251 (1985). https://doi.org/10.1007/BF00279078

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  • DOI: https://doi.org/10.1007/BF00279078

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