Medical Radiology and Radiation Safety. 2024. Vol. 69. № 2

DOI:10.33266/1024-6177-2024-69-2-49-52

I.O. Tomashevsky, O.S. Kornikova

The Importance of Radiation Methods 
in the Diagnosis of Coronary Heart Disease in a Specific Patient

Central Clinical Hospital RZD-Medicine, Moscow, Russia

Contact person: I.O. Tomashevsky, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: Demonstrate a clinical observation in which to establish a diagnosis it was necessary to use eight methods for diagnosing coronary pathology, four of which are radiation.

Material and methods: To establish a diagnosis in a cardiac patient with suspected coronary heart disease (CHD), post-infarction cardiosclerosis, echocardiography (ECG), Holter monitoring (HM), bicycle ergometry (VE), X-ray computed tomography (X-ray computed tomography) to determine calcification of the coronary arteries, single-photon selective computer tomography (SPECT), magnetic resonance computed tomography (MRI), positron emission computed tomography (PET), coronary angiography (CAG).

Results: The sequential use of eight diagnostic methods, four from radiation, was established when observing cardiosclerosis with coronary heart disease, cardiosclerosis in the 4, 5, 10, and 11 segments of the heart, complicated by a left ventricular aneurysm in the lower and lateral walls with minor ischemia at the height of physical activity.  The need to use SPECT/CT in the complex diagnosis of coronary heart disease consists of using hybrid tomography and sequentially performing two studies in one diagnostic procedure (X-ray computed tomography and SPECT with ^99m Tc-technetril) it seems possible to obtain 26 study indicators (with X-ray computed tomography – 4 indicators assessing calcification of the coronary arteries, with SPECT – 11 indicators of perfusion and 11 indicators of myocardial function).

Conclusion: A clinical observation of the diagnosis of coronary artery disease with post-infarction cardiosclerosis and left ventricular aneurysm was demonstrated in which eight diagnostic technologies were used (ECG, CM, VE, CT, SPECT, MRI, PET, and CAG), four of which relate to radiation diagnostics (X-ray CT, SPECT, PET, and KAG). A feature of sequential hybrid tomography (X-ray CT and SPECT with ^99mTc-technitrile) is that this technology allows you to obtain 26 research indicators.

Keywords: radiation diagnostics, heart, x-ray computed tomography, SPECT/CT, ischemic disease

For citation: Tomashevsky IO, Kornikova OS. The Importance of Radiation Methods in the Diagnosis of Coronary Heart Disease in a Specific Patient. Medical Radiology and Radiation Safety. 2024;69(2):49–52. (In Russian). DOI:10.33266/1024-6177-2024-69-2-49-52

References

1. Tomashevskiy I.O., Kornikova O.S. Hybrid Simultaneous ECG-Synchronized Emission and X-Ray Tomography in Assessing the Effect of Coronary Artery Calcinosis on Myocardial Perfusion, as Well as Function, in the Diagnosis of Cardiac Ischemia. Materialy XYII Vserossiyskogo Natsionalnogo Kongressa Luchevykh Diagnostov i Terapevtov «Radiolgiya-2023» = The Collection of Materials of the XYII All-Russian National Congress of Radiation Diagnostics and Therapists “Radiologla-2023”. Moscow Publ., P. 131. ISBN 978-5-906484-71-0 (In Russ.).

2. Khachirova E.A. State of Myocardial Perfusion and Diastolic Function in Patients with Stenocardia and Unchanged Coronary Arteries (According to Hybrid Single-Photon Emission Computed Tomography with ^99mTc-MIBI. Thesis PhD Med. Moscow Publ., 2020 (In Russ.). 

3. Ansheles A.A., Sergiyenko V.B. Nuclear Cardiology. Moscow Publ., 2021. P. 75–125 (In Russ.).

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. I.O. Tomashevsky took part in the development of the concept, design, theoretical basis, modification of research methods. O. Kornikova took part in the collection and analysis of literary material, statistical data processing, writing and scientific editing of the text.

Article received: 20.11.2023. Accepted for publication: 27.12.2023.