Detection of coronary artery disease using real-time myocardial contrast echocardiography: A comparison with dual-isotope resting thallium-201/ stress technectium-99m sestamibi single-photon emission computed tomography

Shoa Lin Lin, Kuan Rau Chiou, Wei Chun Huang, Nan Jing Peng, Daw Guey Tsay, Chun Peng Liu

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6%) by MCE, in 29 patients (41.4%) by WM analysis, and in 30 patients (42.9%) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7% (Kappa = 0.50) to 82.0% (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84%), specificity (93.3%), and accuracy (87.5%) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.

Original languageEnglish
Pages (from-to)226-235
Number of pages10
JournalHeart and Vessels
Volume21
Issue number4
DOIs
Publication statusPublished - Jul 1 2006
Externally publishedYes

Fingerprint

Thallium
Single-Photon Emission-Computed Tomography
Isotopes
Echocardiography
Coronary Artery Disease
Sensitivity and Specificity
Dipyridamole
Perfusion
Coronary Angiography
Fluorocarbons
Coronary Vessels
Angiography
Arteries

Keywords

  • Contrast agent
  • Coronary artery disease
  • Echocardiography
  • Perfusion
  • Single-photon emission computed tomography (SPECT)
  • Wall motion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Detection of coronary artery disease using real-time myocardial contrast echocardiography : A comparison with dual-isotope resting thallium-201/ stress technectium-99m sestamibi single-photon emission computed tomography. / Lin, Shoa Lin; Chiou, Kuan Rau; Huang, Wei Chun; Peng, Nan Jing; Tsay, Daw Guey; Liu, Chun Peng.

In: Heart and Vessels, Vol. 21, No. 4, 01.07.2006, p. 226-235.

Research output: Contribution to journalArticle

@article{b2376b1bf9864c6c8248fec2fa9efc61,
title = "Detection of coronary artery disease using real-time myocardial contrast echocardiography: A comparison with dual-isotope resting thallium-201/ stress technectium-99m sestamibi single-photon emission computed tomography",
abstract = "Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6{\%}) by MCE, in 29 patients (41.4{\%}) by WM analysis, and in 30 patients (42.9{\%}) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7{\%} (Kappa = 0.50) to 82.0{\%} (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84{\%}), specificity (93.3{\%}), and accuracy (87.5{\%}) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.",
keywords = "Contrast agent, Coronary artery disease, Echocardiography, Perfusion, Single-photon emission computed tomography (SPECT), Wall motion",
author = "Lin, {Shoa Lin} and Chiou, {Kuan Rau} and Huang, {Wei Chun} and Peng, {Nan Jing} and Tsay, {Daw Guey} and Liu, {Chun Peng}",
year = "2006",
month = "7",
day = "1",
doi = "10.1007/s00380-005-0890-0",
language = "English",
volume = "21",
pages = "226--235",
journal = "Heart and Vessels",
issn = "0910-8327",
publisher = "Springer Japan",
number = "4",

}

TY - JOUR

T1 - Detection of coronary artery disease using real-time myocardial contrast echocardiography

T2 - A comparison with dual-isotope resting thallium-201/ stress technectium-99m sestamibi single-photon emission computed tomography

AU - Lin, Shoa Lin

AU - Chiou, Kuan Rau

AU - Huang, Wei Chun

AU - Peng, Nan Jing

AU - Tsay, Daw Guey

AU - Liu, Chun Peng

PY - 2006/7/1

Y1 - 2006/7/1

N2 - Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6%) by MCE, in 29 patients (41.4%) by WM analysis, and in 30 patients (42.9%) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7% (Kappa = 0.50) to 82.0% (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84%), specificity (93.3%), and accuracy (87.5%) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.

AB - Real-time myocardial contrast echocardiography (MCE) has the potential to evaluate myocardial perfusion and wall motion (WM) simultaneously. The purposes of this study were to correlate the diagnostic value of MCE with radionuclide single-photon emission computed tomography (SPECT), and to assess the sensitivity and specificity of real-time MCE in detecting coronary artery disease (CAD). Seventy patients with clinically suspected CAD underwent MCE and SPECT at baseline and after dipyridamole infusion. Segmental perfusion with MCE using low mechanical index after 0.3-0.4-ml bolus injections of perfluorocarbon exposed sonicated dextrose albumin solution was performed. All patients had a dual-isotope (rest thallium-201, stress sestamibi) study performed both at baseline and after dipyridamole infusion, and 40 patients had subsequent quantitative coronary angiography. Abnormalities were noted in 27 patients (38.6%) by MCE, in 29 patients (41.4%) by WM analysis, and in 30 patients (42.9%) by SPECT imaging. When MCE and WM analysis were combined, the agreement with SPECT imaging improved from 75.7% (Kappa = 0.50) to 82.0% (Kappa = 0.62). In 40 patients (120 territories) who underwent coronary angiography, good perfusion concordance was achieved for the left anterior descending and left circumflex arteries, and was fair for the right coronary arteries. Compared with quantitative angiography, there was no difference in sensitivity, specificity, and accuracy in detecting significant CAD among the three modalities. The combination of MCE and WM had a better sensitivity (84%), specificity (93.3%), and accuracy (87.5%) than the MCE and WM analysis alone. However, the difference did not reach statistical significance. Real-time MCE has a good agreement with SPECT imaging for detecting CAD. The combination of MCE and WM appears to have higher sensitivity, specificity, and accuracy in detecting CAD than either technique alone.

KW - Contrast agent

KW - Coronary artery disease

KW - Echocardiography

KW - Perfusion

KW - Single-photon emission computed tomography (SPECT)

KW - Wall motion

UR - http://www.scopus.com/inward/record.url?scp=33748426209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748426209&partnerID=8YFLogxK

U2 - 10.1007/s00380-005-0890-0

DO - 10.1007/s00380-005-0890-0

M3 - Article

C2 - 16865298

AN - SCOPUS:33748426209

VL - 21

SP - 226

EP - 235

JO - Heart and Vessels

JF - Heart and Vessels

SN - 0910-8327

IS - 4

ER -