Abstract 15274: Clinical Utility of Dynamic Stress Perfusion Cardiac CT in Asymptomatic Diabetic Patients Using 128 Slice Dual Source Computed Tomography
Background: Assessment of coronary artery disease (CAD) using cardiac computed tomography (CT) in asymptomatic diabetic patients has not been recommended because possible radiation hazard and limitation of CT angiography (CTA) for functional assessment. Recently, dynamic stress perfusion cardiac CT using dual source CT showed tolerable radiation dose and reliable correlation with stress cardiac magnetic resonnance imaging (CMR) or invasive coronary angiography. We analyzed the feasibility and clinical utility of stress perfusion cardiac CT in asymptomatic diabetic patients.
Methods: Asymptomatic type 2 diabetic patients aged from 40 to 70 years old were consecutively enrolled. Patients who had renal failure or contraindication for CT or adenosine were excluded. Stress perfusion CT was first acquired using sequence mode during adenosine infusion, and scanning for CTA was followed by helical mode using 128-slice dual source CT. CT image was analyzed by 2 independent readers.
Results: Finally, 217 patients underwent stress perfusion cardiac CT and 213 patients (98%) successfully complete the study. Diabetes duration was 8.8±6.7 years. Radiation dose was 11.38±4.35mSv and total contrast volume was 114±13mL. Significant coronary stenosis more than 50% was found in 47 patients (22%) and stress-induced perfusion defect was found in 21 patients (10%). Among them, matched perfusion defect to coronary artery stenosis was found only in 11 patients (5.2%). Stress CMR was performed for the 39 patients with significant coronary stenosis and sensitivity and specificity of stress perfusion CTA (matched stress perfusion as a positive) was 83% and 80% respectively, when CMR is considered as a standard method.
Conclusion: Stress perfusion cardiac CT can visualize the atherosclerotic burden of coronary artery, and also provide the functional information for CAD in asymptomatic diabetic patients. Future investigation is required whether performance of stress perfusion cardiac CT can improve the prognosis of diabetic patients.
- © 2011 by American Heart Association, Inc.