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CMR Versus SPECT: Which is Better?

by Dr. Simi Paknikar on Feb 14 2012 2:30 PM
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Cardiovascular magnetic resonance or CMR is more sensitive in diagnosing problems related to the heart, according to a recent study.

A number of techniques are used to diagnose blocks in the arteries supplying to the heart. These techniques help the cardiologist decide if the person requires angioplasty. Coronary angiography, in which a dye is injected into the coronary arteries, is a procedure that checks the structure of the blood vessels supplying to the heart. Some of the newer techniques are designed to test the function of the heart. These include SPECT and CMR.

SPECT or single-photon emission computed tomography is a procedure in which the patient is administered a radioactive substance though an injection. The radioactive substance moves along the blood flow. Images are then taken with a special camera. Areas with reduced blood flow are thus detected. The disadvantages of this procedure are varying degrees of accuracy and exposure of the patient to radiation.

Cardiovascular magnetic resonance or CMR, also known as cardiac MRI, is another new technique that may be used as an alternative to SPECT. Like other MRIs, it produces a powerful magnetic field to study the heart. It has the advantage that it does not expose the patient to radiation. It can detect multiple problems of the heart during a single examination including those affecting the heart muscles or the blood vessels supplying to the heart.

A recent study compared the sensitivity of SPECT and CMR in angina patients requiring a cardiac investigation. The patients underwent the procedures of x-ray coronary angiography, SPECT and CMR.

The study found that CMR was more sensitive in diagnosing clinically significant heart disease in suspected cases of angina as compared to SPECT. CMR however is not useful in patients with claustrophobia, wide abdominal girth and presence of medical implants.

The study thus suggests that CMR is superior to SPECT in diagnosing problems related to a reduction in blood flow to the heart, and should be used more often. However, the costs of the procedure should also be considered while opting for a particular procedure.

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Reference:

1. Cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary heart disease (CE-MARC): a prospective trial; Dr. John Greenwood et al; The Lancet, Volume 379, Issue 9814, Pages 453 – 460.

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