核素心肌灌注显像与多层螺旋CT诊断冠心病的对比分析  

Diagnostic value of myocardial perfusion imaging and multisliee spiral computed tomography for coronary artery disease

作　　者：唐坤[1] 史蓉芳[1] 赵晓斌[1] 董智[2] 李婷[1] 

机构地区：[1]泰达国际心血管病医院核医学科,天津300457 [2]泰达国际心血管病医院放射科,天津300457

出　　处：《中华心血管病杂志》2008年第9期816-819,共4页Chinese Journal of Cardiology

摘　　要：目的对比分析核素心肌灌注显像（MPI）与多层螺旋CT（MSCT）对冠心病（CAD）的诊断价值，并评价两者联合诊断CAD的临床价值。方法对43例患者（疑诊CAD36例，确诊CAD7例）行冠状动脉造影（CAG）、MPI和MSCT检查，且三项检查均在2个月内进行。采用半定量法对MPI结果进行分析，SDS（总差值分）〉1判定为可逆性心肌缺血，并将各心肌节段定位于其所对应的冠状动脉；参照国际上通用的目测直径法对MSCT结果进行判定，即至少1支主要冠状动脉或其主要分支狭窄程度I〉50％判定为阳性。以CAG为诊断CAD的“金标准”，比较MPI与MSCT对CAD患者的诊断价值和对病变血管（狭窄程度≥50％）的检出价值。结果MPI和MSCT对CAD患者诊断的灵敏性、特异性及准确性分别是79．17％、84．21％及81．40％和83．33％、89．47％及86．05％；MPI和MSCT对病变血管诊断的灵敏性、特异性及准确性分别是53．19％、89．02％及75．97％和70．21％、95．12％及86．05盼，两者差异均无统计学意义（P〉0．05）。结论MPI和MSCT诊断CAD差异无统计学意义。两者优势互补，是筛选、诊断CAD的无创性检查手段，宜结合使用。Objective To investigate the diagnostic value of myocardial perfusion imaging （MPI） and multislice spiral computed tomography （MSCT） for coronary artery disease （CAD）. Methods Coronary angiography （CAG）, MPI and MSCT were performed in 43 patients （36 with suspected, 7 with known CAD）. MPI examinations were evaluated semiquantitatively by agreement of two experienced observers. SDS （summed difference score） 〉 1 was defined as reversible ischemia, and each myocardial segment was allocated to the territory of one of the coronary arteries. The MSCT results were defined as positive when stenoses （ ≥50% ） were found in one main vessel or its main branch vessel. CAG results served as ＂gold standard＂. The diagnostic values of MPI and MSCT for CAD were compared respectively on patient basis and on vessel basis. Results On patient basis, the sensitivity, specificity and accuracy of MPI for diagnosing CAD were 79. 17%, 84. 21% and 81.40% which were similar as those of MSCT： 83.33%, 89.47% and 86. 05% （all P〉0. 05）. On vessel basis, the sensitivity, specificity and accuracy of MPI were 53.19%, 89.02% and 75.9/% which were also similar to those of MSCT： 70. 21%, 95.12% and 86. 05% （ all P 〉 0.05）. Conclusion The non-invasive MPI and MSCT provide satisfactory and similar diagnostic information on diagnosing CAD.

关 键 词：冠状动脉疾病 体层摄影术 发射型计算机 单光子 心血管造影术 多层螺旋CT 

分 类 号：R686[医药卫生—骨科学]