^(13)N-NH_3 PET腺苷负荷-静息心肌灌注显像联合冠状动脉CT血管造影对冠心病的诊断价值  

Diagnosis of Coronary Artery Disease Using Fused Adenosine Stress-rest Myocardial Perfusion ^(13)N-NH_3 PET Imaging with Coronary CT Angiography

作　　者：张国建[1] 王雪梅[1] 

机构地区：[1]内蒙古医科大学附属医院核医学科PET/CT中心,内蒙古呼和浩特010050

出　　处：《中国医学影像学杂志》2013年第7期517-521,共5页Chinese Journal of Medical Imaging

基　　金：内蒙古自治区卫生厅医疗卫生科研计划项目(2010041);内蒙古自然科学基金面上项目(2012MS1153)

摘　　要：目的评价13N-NH3PET腺苷负荷-静息心肌灌注显像(MPI)与冠状动脉CT血管造影(CTA)图像融合诊断冠心病的价值。资料与方法 30例可疑冠心病患者均行13N-NH3PET腺苷负荷-静息MPI及冠状动脉CTA显像,1个月内行冠状动脉造影(CAG),以CAG结果作为诊断标准,比较CTA、MPI及CTA联合MPI诊断冠心病的效能。结果 CTA与CAG检查结果比较,差异有统计学意义(P<0.05);MPI及CTA联合MPI与CAG检查结果比较,差异无统计学意义(P>0.05)。以CAG结果作为参照标准,CTA、MPI及CTA联合MPI诊断冠心病的敏感度分别为90.0%、85.7%、95.2%,特异度分别为94.9%、88.9%、100.0%,准确度分别为94.3%、86.7%、96.7%,阳性预测值分别为70.6%、94.7%、100.0%,阴性预测值分别为98.6%、72.7%、90.0%。三者诊断冠心病的敏感度、特异度、准确度、阳性预测值和阴性预测值比较,差异均有统计学意义(χ2=7.058、10.331、8.946、28.713、13.451,P<0.01)。结论 13N-NH3PET腺苷负荷-静息MPI与冠状动脉CTA的功能-解剖图像融合可以做到优势互补,避免单纯PET或CTA造成的假阳性和假阴性,能明显提高冠心病的诊断准确性,是目前诊断冠心病的科学方法。Purpose To evaluate the diagnostic value of fused adenosine stress-rest myocardial perfusion ^13N-NH3 PET myocardial perfusion imaging （MPI） with coronary CT angiography （CTA） in coronary artery disease （CAD）. Materials and Methods 30 patients with suspected coronary artery disease underwent adenosine stress-rest myocardial perfusion ^13N-NH3 PET and coronary CT angiography, followed by coronary angiography within one month as the standard of reference. The diagnostic efficacy of CTA, MPI and combined CTA/MP1 was determined. Results The accuracy of CTA was significantly different from CAG （P〈0.05）; MPI and combined CTA/MPT were not significantly different in diagnosing CAD （P〉0.05）. The sensitivity of CTA, MPl and combined CTA/ MPI was 90.0%, 85.7% and 95.2%, with specificity of 94.9%, 88.9%, 100.0%, accuracy of 94.3%, 86.7%, 96.7%; positive predictive value of 70.6%, 94.7%, 100.0% and positive predictive value of 98.6%, 72.7%, 90.0% respectively. There was statistical significances in sensitivity, specificity, accuracy, positive predictive value and negative predictive value （χ2=7.058, 10.33 1, 8.946, 28.713, 13.451, P〈0.01）. Conclusion Fused adenosine stress- rest myocardial perfusion ^13N-NH3 PET imaging with coronary CTA increases diagnostic accuracy in CAD.

关 键 词：冠心病 正电子发射断层显像术 13N-NH3 心肌灌注成像 冠状血管造影术 体层摄影术 X线计算机 图像处理 计算机辅助 

分 类 号：R541.4[医药卫生—心血管疾病] R445[医药卫生—内科学]