心肌灌注断层显像定量分析法和短暂性缺血扩张在冠状动脉疾病诊断中的应用价值  

Diagnostic value of quantitative analysis and transient ischemic dilation on ^(99m)Tc-MIBI myocardial perfusion imaging in coronary artery disease

作　　者：李环[1] 颜珏[1] 李晓鸣[1] 袁贺匀[1] 崔霞[1] 刘鸿娥[1] 

机构地区：[1]中日友好医院核医学科,北京100029

出　　处：《中日友好医院学报》2007年第2期82-84,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:研究心肌灌注断层显像中定量分析法在冠状动脉疾病(CAD)诊断中的价值,并探讨短暂性缺血扩张(TID)对评价CAD严重程度的价值。方法:70例拟诊冠心病患者,平均年龄62.5±11.3岁。均进行潘生丁(双嘧达莫)负荷-静息99mTc-MIBI心肌灌注断层显像和冠状动脉造影检查。计算机软件自动进行定量分析,并得到TID值。结果:视觉分析法和定量分析法的敏感性、特异性、准确率、假阳性率分别为70.83%、68.18%、70.00%、17.07%和87.50%、90.91%、88.57%、4.55%。各组TID值均值:3支病变1.21±0.10;2支病变1.02±0.14;1支病变1.05±0.11;冠脉造影阴性者0.97±0.10。3支病变的TID值与阴性组比较有显著差异(P<0.01)。单支病变中狭窄程度与TID值显著相关(γ=0.619,P<0.05)。结论:定量分析法能够较视觉分析更好地确定冠状动脉疾病,并且能够确定冠状动脉狭窄部位和程度。TID值可以作为诊断冠脉疾病,尤其是严重的、广泛的冠脉病变的很有价值的指标。Objective：To investigate the diagnostic value of quantitative analysis method on myocardial perfusion imaging for coronary artery disease（CAD）and the value of transient ischemic dilation（TID）for assessing severity of CAD.Methods：Dipyridamole stress and rest ^99mTc- MIBI imaging were performed in 70 patients with known angiography.Using visual analysis and computer-based quantitative analysis programs to interpret images.TID values were acquired by computer automatically.Results：The sensitivity,specificity,accuracy and false positivity of visual and quantitative analysis were 70.83%, 68.18%,70.00%, 17.07% and 87.50%, 90.91%, 88.57%,4.55%, respectively.Mean values of TID in 4 groups （groups of 3 vessels,2 vessels and single vessel lesion,normal group） were 1.21±0.10,1.02±0.14,1.05±0.11 and 0.97±0.10,respectively.There was significant difference between 3 vessels lesion and normal group （P〈0.01）.TID value was relative to the extent of vessel stenosis （γ=0.619, P〈0.05）.Conclusion：Compared with visual analysis,quantitative analysis can improve diagnostic accuracy,sensitivity,specificity and confirming the site and extent of stenosis. TID value can be a useful index for diagnosing CAD,especially for severe and extensive CAD.

关 键 词：冠状动脉疾病 体层摄影术 发射型计算机 单光子 甲氧异丁基异腈 

分 类 号：R541.4[医药卫生—心血管疾病]