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Imaging for Coronary Artery Disease Diagnosis Examined

Computed tomography and magnetic resonance imaging provide complementary capabilities

FRIDAY, Jan. 29 (HealthDay News) -- Computed tomographic (CT) angiography and first-pass magnetic resonance (MR) myocardial perfusion imaging provide complementary capabilities; the first to detect or rule out coronary artery disease (CAD), and the second to detect any resulting myocardial ischemia, according to a study in the February issue of Radiology.

Jan G.J. Groothuis, M.D., of the VU University Medical Center in Amsterdam, Netherlands, and colleagues performed both CT angiography and first-pass MR imaging in 145 patients with chest pain and low-to-intermediate probability of CAD. The images produced by the two modalities were assessed for their ability to diagnose CAD and myocardial ischemia.

The researchers found that CT coronary angiography identified obstructive CAD in 35.9 percent of patients and 17.9 percent of coronary arteries. MR myocardial perfusion imaging found myocardial ischemia in 22.8 percent of patients and 13.6 percent of vessels. Among patients in which coronary CT angiography failed to find CAD, or CAD was non-obstructive, MR myocardial perfusion imaging was normal in 90.5 and 83.3 percent of cases, respectively. The authors further note that MR myocardial perfusion imaging detected myocardial ischemia in 42.3 percent of patients in whom coronary CT angiography found obstructive CAD.

"MR myocardial perfusion imaging and coronary CT angiography have complementary roles in evaluation of patients who are suspected of having CAD. Coronary CT angiography can be used to reliably rule out CAD, but its capability to demonstrate hemodynamically significant CAD is limited. The combination of both techniques enables the clinician to evaluate morphology and functional relevance of CAD comprehensively and noninvasively," Groothuis and colleagues conclude.

One of the study authors reported receiving research support from Siemens.

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