CT冠状动脉造影结合心肌灌注显像检测血流受阻型冠状动脉病变  

CT coronary angiography combined with adenosine stress myocardial perfusion scintigraphy for detecting flow-limiting coronary stenoses

作　　者：汪奇[1] 秦静[2] 王志国[1] 关志伟[1] 董蔚[1] 孙志军[1] 盖鲁粤[1] 陈韵岱[1] 田嘉禾[3] 杨立[4] 

机构地区：[1]解放军总医院心内科,北京100853 [2]武警总医院超声科,北京100039 [3]解放军总医院核医学科,北京100853 [4]解放军总医院放射科,北京100853

出　　处：《南方医科大学学报》2011年第2期210-215,共6页Journal of Southern Medical University

基　　金：国家"十一五"科技支撑计划(2006BAI01A02)~~

摘　　要：目的探讨CT冠状动脉造影(CTCA)结合腺苷负荷核素心肌灌注显像(MPS)无创地检测血流受阻型冠脉阻塞性病变的可行性与准确性。方法 105例怀疑或诊断为冠心病的患者,有创性冠状动脉造影检查前4周内完成CTCA与腺苷负荷MPS检查。以定量冠状动脉造影结合MPS的结果为参照,评价CTCA结合MPS诊断血流受阻型冠脉阻塞性病变的准确性及作为再血管化治疗"看门人"的可行性。结果对比定量冠状动脉造影结合MPS结果,CTCA结合MPS诊断血流受阻型冠脉阻塞性病变的敏感性、特异性、阳性预测值及阴性预测值均为100%。16%的再血管化治疗患者中并未发现血流受阻型冠脉阻塞性病变。结论对比定量冠状动脉造影结合MPS的结果,CTCA结合腺苷负荷MPS可以准确地检测血流受阻型的冠脉阻塞性病变,可以充当再血管化治疗的"看门人"。Objective To assess the feasibility and accuracy of CT coronary angiography（CTCA） combined with adenosine stress myocardial perfusion scintigraphy（MPS） for diagnosis of flow-limiting coronary stenosis.Methods A total of 105 patients with suspected or established coronary artery disease（CAD） underwent CTCA and MPS within 4 weeks before invasive coronary angiography.The accuracy of CTCA/MPS in the diagnosis of flow-limiting coronary stenosis was evaluated in comparison with the results of quantitative coronary angiography and MPS.Results The sensitivity,specificity,positive predictive value and negative predictive value of CTCA/MPS as a combined approach for detection of flow-limiting coronary stenosis were all 100%.In 16%（9/55） of the patients,revascularization procedures were performed and no flow-limiting stenosis was found.Conclusion Combination of CTCA and MPS has an excellent accuracy for detecting flow-limiting coronary stenosis as compared with quantitative coronary angiography/MPI,and can be a useful ＂gatekeeper＂ for revascularization procedures.

关 键 词：CT冠状动脉造影 心肌灌注显像 冠状动脉造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]