腺苷负荷^99m锝-甲氧基异丁基异腈门控心肌灌注显像在冠心病诊断中的价值  

The Clinical Value of Adenosine Stress ^(99m)Tc-MIBI Gated Myocardial Perfusion Imaging in Diagnosis of Coronary Artery Disease

作　　者：王丽娟[1] 李晓鹃[1] 孙英贤[1] 李娜[2] 李亚明[2] 

机构地区：[1]中国医科大学附属第一医院心内科,辽宁省沈阳市110001 [2]中国医科大学附属第一医院核内科,辽宁省沈阳市110001

出　　处：《中国循环杂志》2011年第3期170-173,共4页Chinese Circulation Journal

基　　金：辽宁省科技攻关计划课题(No.2007225004-2);“十一五”国家科技支撑计划课题(2007BA105B01)

摘　　要：目的:探讨腺苷负荷99m锝—甲氧基异丁基异腈(99mTc-MIBI)门控心肌灌注显像(G-MPI)诊断冠心病、评价冠状动脉(冠脉)病变及左心室功能的临床价值。方法:46例临床确诊或疑似的冠心病患者,分别行腺苷负荷99mTc-MIBI G-MPI及选择性冠脉造影检查,以冠脉造影为金标准,计算腺苷负荷G-MPI诊断冠心病及冠脉不同血管病变的敏感性、特异性及准确性,同时比较腺苷负荷99mTc-MIBI G-MPI的左心室射血分数(LVEF)与超声心动图的LVEF的相关性。结果:腺苷负荷99mTc-MIBI G-MPI诊断冠心病的敏感性为87.0%,特异性为81.8%,准确性为85.3%,阳性预测值为90.9%,阴性预测值为75.0%。它对判断冠脉各分支狭窄也具有较高的价值,其中左前降支敏感性为88.2%、特异性为81.8%、准确性为86.7%;左回旋支敏感性为78.6%、特异性为90.9%、准确性为84.0%;右冠脉敏感性为90.5%,特异性为72.7%,准确性为84.4%。而且,对冠脉病变支数的检出率分别为1支病变83.3%,2支病变91.7%,3支病变90.9%。腺苷负荷99mTc-MIBI G-MPI的LVEF与超声心动图的LVEF无显著差异,二者呈显著正相关(r=0.885,P=0.0001)。结论:腺苷负荷99mTc-MIBI G-MPI对诊断冠心病、评价冠脉病变及左心室功能具有重要的临床价值。Objective：To investigate the clinical value of adenosine stress ^99mTc-methoxyisobutylisonitrile （^99mTc-MIBI） gated myocardial perfusion imaging （G-MPI） in diagnosis of coronary artery disease （CAD）, in evaluation of coronary artery branch stenosis and left ventrieular function. Methods： A total of 46 patients diagnosed or suspected for CAD, all patients underwent coronary artery angiography （CAG） as golden standard, and meanwhile, the paiients received adenosine stress ^99mTc-MIBI G-MPI examination. We calculated the sensitivity, specificity and accuracy of adenosine stress G-MPI in diagnosing CAD and judging coronary artery stenosis, we also compared the left ventricular ejection fraction （LVEF） between adenosine stress ^99mTc-MIBI G-MPI and ultrasonic echoeardiography （UCG）. Results： The adenosine stress 9^99mTc-MIBI G-MPI for CAD diagnosis had the sensitivity：87.0%, specificity：81.8%, accuracy：85.3% ,positive predictive value：90. 9% and negative predictive value：75. 0%. The diagnostic sensitivity, specificity and accuracy for left anterior descending artery stenosis were 88.2% , 81. 8% , 86. 7% respectively, for left circumflex artery stenosis were 78. 6% , 90. 9% , 84. 0% respectively, for right coronary artery stenosis were 90. 5% , 72.7% , 84.4% respectively. The positive diagnostic rate for 1 branch vessel：83.3%, for 2-ranch vessel：91.7%, for 3-ranch vessel：90. 9%. There was no real difference in LVEF-G-MPI and LVEF-UCG, it had a positive correlation coefficient （r=0. 885, P=0. 0001 ）. Conclusion ：Adenosine stress ^99mTc-MIBI G-MPI has significant clinical value for diagnosing CAD and for evaluating coronary artery branch stenosis and left ventricular function.

关 键 词：腺苷 ^99M锝-甲氧基异丁基异腈 门控心肌灌注显像 冠状动脉造影 冠状动脉疾病 左心室功能 

分 类 号：R541[医药卫生—心血管疾病]