Erschienen in:
01.02.2012 | Nuclear Cardiology Bullet
Zero coronary calcium in the presence of severe isolated left main stenosis detected by CT coronary angiography in a patient with typical angina and equivocal myocardial perfusion SPECT
verfasst von:
J. Schaap, MD, R. M. Kauling, MD, S. M. Boekholdt, MD, PhD, M. C. Post, MD, PhD, J. A. Van der Heyden, MD, T. L. de Kroon, MD, B. J. W. M. Rensing, MD, PhD, J. F. Verzijlbergen, MD, PhD
Erschienen in:
Journal of Nuclear Cardiology
|
Ausgabe 1/2012
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Excerpt
With the advent of integrated single-photon emission computed tomography (SPECT) and computed tomography (CT) systems and the use of low-dose coronary calcium-scoring (CCS) scans for attenuation correction purposes, high-quality anatomical and functional data become readily available for patients with suspected coronary artery disease (CAD).
1,
2 Myocardial ischemia detected by nuclear perfusion imaging is associated with high CCS. Vice versa, it has been suggested that a low CCS in these patients could obviate the need for further invasive testing.
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4 However, in patients with a normal myocardial perfusion SPECT, a high CCS could be suggestive of significant CAD.
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7 In the current case report, we present a patient with intermediate pre-test likelihood of CAD who was referred for SPECT scanning. She was enrolled in a prospective study to evaluate the additive value of CT coronary angiography (CT-A) to SPECT in the diagnosis of significant CAD. In this case, no coronary calcium was present and the result of the SPECT study was equivocal. CT-A showed a severe left main stenosis, which was confirmed by invasive coronary angiography (CA). …
