The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other. 1. Introduction Myocardial perfusion imaging (MPI) with single-photon emission computer tomography (SPECT) is the most commonly used and well-documented noninvasive method for diagnosis and risk stratification of coronary artery disease (CAD) [1]. The location and extent of ischemia can be reliably and semiquantitatively obtained using MPI, which plays an important role for patient management. The latest advancements for computed tomography (CT), such as faster gantry, multidetector array, and even dual-source detectors, make it possible to noninvasively and intuitively obtain anatomic morphology of coronary arteries, especially contributing to identifying the magnitude, distribution, and composition of coronary atherosclerosis. It has been documented that CT coronary angiography (CTCA) has high accuracy in detection of obstructive CAD comparing with invasive coronary angiography (ICA) [2]. As noninvasive diagnostic methods of CAD for both MPI and CTCA, how to correctly recognize the respective role and relationship between them in diagnosing and evaluating CAD is a very important question concerned by clinicians. This study aims to discuss and evaluate the relationship and difference between SPECT MPI and CTCA through comparative analysis. 2.
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