DIAGNOSTIC-ACCURACY OF TOMOGRAPHIC MYOCARDIAL, IMAGING FOR DETECTION OF RESTENOSIS AFTER CORONARY ANGIOPLASTY

Introduction and objectives. To analyze the efficacy of single photon emission tomography (SPET) with Tc-99m-compounds for the diagnosis of restenosis of previous percutaneous transluminal coronary angioplasty (PTCA). Patients and methods. Seventy-one patients (16 women, median a ge: 60 years, 35 with multivessel disease, 78 arteries with PTCA) with previous PTCA and with coronary angiography performed after scintigra phy were studied. Tc-99m-SPET exercise (53 with MIBI and 18 with tetro fosmin) was performed, for clinical reasons, to all patients between o ne month and 4 years after PTCA. Intravenous dipyridamole was administ ered simultaneously to 16 patients who had insufficient exercise. Resu lts. SPET sensitivity, specificity, positive predictive values, negati ve predictive values and global values were all significantly higher t han those obtained with exercise tests (80% vs 63%; p = 0.05; 83% vs 3 7%; p = 0.001; 91% vs 69%; p = 0.007; 64% vs 31%; p = 0.009, and 81% v s 55%; p = 0.0006, respectively). These results were significantly sup erior in patients with one vessel disease than in patients with multiv essel disease. Conclusions. SPET exercise with Tc-99m-compounds is a t est with a high efficacy for the diagnosis of post-PTCA restenosis, ma inly in patients with one vessel disease.