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.