Usefulness of integrated dual-source multislice computed tomography and cardiac SPECT in a patient with previous myocardial infarction

we present the case of a 62-year-old woman with chest pain and a history of an inferior myocardial infarction for which she underwent stenting in the right coronary artery. patient was evaluated by cardiac spect and the recently introduced dual-source computed tomography (dsct) system (equipped with two x-ray tubes and two corresponding detectors), in order to detect ischemia associated to stent restenosis. in this case, dsct demonstrated a very high diagnostic performance to exclude in-stent restenosis, using a dual-energy protocol, and clearly showed subendocardial distribution of the myocardial perfusion defect, in contrast with the transmural defect seen in the spect images. as a result, the integration of a dual-energy ct protocol for the evaluation of myocardial blood pool during the assessment of coronary anatomy in this patient, may redefine the diagnostic power of dsct.