Charline Zadro1,2, Noé Roussel1,2, Emmanuelle Cassol2,3,4, Pierre Pascal2,3, Antoine Petermann1,2, Olivier Meyrignac1,2, Marion Jaffro1,2, Pauline Fournier2,5, Maxime Cournot6, Michel Galinier2,4,5, Didier Carrié5, Hervé Rousseau1,2,4, Isabelle Berry2,3,4, Olivier Lairez7,8,9,10. 1. Department of Radiology, Toulouse University Hospital, Toulouse, France. 2. Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France. 3. Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. 4. Medical School of Rangueil, University Paul Sabatier, Toulouse, France. 5. Department of Cardiology, University Hospital of Rangueil, Toulouse, France. 6. Department of Cardiology, Gabriel Martin Hospital, Saint-Paul, France. 7. Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France. Lairez@gmail.com. 8. Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. Lairez@gmail.com. 9. Medical School of Rangueil, University Paul Sabatier, Toulouse, France. Lairez@gmail.com. 10. Department of Cardiology, University Hospital of Rangueil, Toulouse, France. Lairez@gmail.com.
Abstract
BACKGROUND: Attenuation correction computed tomography (CT) contributes to an improvement in the diagnostic accuracy of myocardial perfusion imaging (MPI) by single photon emission tomography (SPECT). The aim of this study was to explore the prognosis of patients with major findings by CT according to the results of MPI. METHODS AND RESULTS: 1506 patients who underwent MPI by SPECT were retrospectively included. Attenuation correction CT images were systematically analyzed for major and minor abnormalities. 830 (55.1%) and 212 (14.1%) patients had minor and major extracardiac findings, respectively. Among patients with major extracardiac findings, the abnormality was previously unknown in 113 (53.3%) patients. 90 (41.9%) had abnormal MPI, 73 (34.4%) had a myocardial infarction scar, 55 (25.9%) had myocardial ischemia, and 38 (17.7%) patients had both myocardial infarction scar and myocardial ischemia. Among the 201 patients available for survival analysis, there were 67 (31.2%) deaths over a follow-up period of 3.2±1.3 years. There was no significant impact on survival arising from MPI, whatever the result. The results were the same among the 103 patients with previously unknown major extracardiac findings. CONCLUSION: Extracardiac findings by CT during MPI are frequent. Patients with major extracardiac findings have a poor mid-term outcome, whatever the results of the myocardial perfusion imaging. Extracardiac findings should be systematically checked when attenuation correction CT is performed.
BACKGROUND: Attenuation correction computed tomography (CT) contributes to an improvement in the diagnostic accuracy of myocardial perfusion imaging (MPI) by single photon emission tomography (SPECT). The aim of this study was to explore the prognosis of patients with major findings by CT according to the results of MPI. METHODS AND RESULTS: 1506 patients who underwent MPI by SPECT were retrospectively included. Attenuation correction CT images were systematically analyzed for major and minor abnormalities. 830 (55.1%) and 212 (14.1%) patients had minor and major extracardiac findings, respectively. Among patients with major extracardiac findings, the abnormality was previously unknown in 113 (53.3%) patients. 90 (41.9%) had abnormal MPI, 73 (34.4%) had a myocardial infarction scar, 55 (25.9%) had myocardial ischemia, and 38 (17.7%) patients had both myocardial infarction scar and myocardial ischemia. Among the 201 patients available for survival analysis, there were 67 (31.2%) deaths over a follow-up period of 3.2±1.3 years. There was no significant impact on survival arising from MPI, whatever the result. The results were the same among the 103 patients with previously unknown major extracardiac findings. CONCLUSION: Extracardiac findings by CT during MPI are frequent. Patients with major extracardiac findings have a poor mid-term outcome, whatever the results of the myocardial perfusion imaging. Extracardiac findings should be systematically checked when attenuation correction CT is performed.
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