^(13)N-Ammonia PET心肌灌注显像与CT冠状动脉造影在冠心病诊断中的价值比较  

Value of ^(13)N-ammonia PET myocardial perfusion imaging and coronary computed tomography angiography in diagnosis of coronary artery disease

作　　者：方雷[1] 安建平[1] 赵辉[1] 毛军峰[1] 李运[1] 代伟[1] 

机构地区：[1]兰州军区兰州总医院PET/CT中心,730050

出　　处：《安徽医学》2013年第9期1380-1383,共4页Anhui Medical Journal

摘　　要：目的研究PET/CT一体机一站式13N-Ammonia PET静息/负荷心肌灌注显像与CT冠状动脉造影(CCTA)在冠心病(CAD)中的诊断价值。方法利用64排PET/CT对35例临床怀疑有中度罹患CAD风险患者进行一站式检查,先行13N-Ammonia PET静息/负荷心肌灌注显像,后行CCTA。结果 29例患者(82.9%)被CCTA诊断为冠状动脉粥样硬化(其中18例患者被诊断为重度狭窄,狭窄程度≥50%,18例患者中12例总压力积分>12),同机PET 24例患者(82.8%)显示心肌缺血。另外6例患者均被CCTA诊断为正常,其中3例同机PET显示心肌缺血;CCTA与PET诊断心肌缺血的一致性为93%;排除心肌缺血的一致性为37%;CCTA与PET诊断冠脉粥样硬化的一致性是83%;排除冠脉粥样硬化的一致性为50%。结论 CCTA诊断冠脉狭窄与PET诊断心肌缺血有很强的一致性;但对于轻度冠脉狭窄,PET静息/负荷心肌灌注显像在显示心肌缺血方面具有重要价值。Objective To investigate the functional impact of coronary artery in patients with suspected coronary artery disease （CAD） using integrated positron emission tomography （PET） and coronary computed tomography angiography （CCTA） scan obtained on the same PET/CT scanner. Methods We investigated 35 patients with clinically suspected moderate risk for CAD by means of a hybrid PET/CT 64 slice scanner. A rest/adenosine stress 13N - ammonia PET was performed firstly for myocardial perfusion assessment, then CCTA was per- formed for coronary anatomy evaluation. Results 29/35 （82.9%） patients with atherosclerosis were detected with CCTA; 18 patients had significant （ 〉150% ） coronary stenoses and all 18 patients were diagnosed with isehemia by PET; moreover, 12/18 patients had a Summed Stress Score 〉 12. 24/29 and 83.9% patients with atherosclerosis diagnosed by CCTA showed ischemia by PET. 3/6 patients with normal coronary arteries were detected to have ischemia by PET. CCTA agreement in positive identification of PET ischemia was 91% and agreement in excluding ischemia was 37% ; PET agreement in diagnosing CCTA atherosclerosis was 83% , and agreement in excluding it was 50%. Conclusion There is a strong correlation between significant coronary stenosis detected by CCTA and ischemia by PET. However, as for low - grade stenosis, PET scan can demonstrate the functional significance of atherosclerotic abnormalities.

关 键 词：冠心病 计算机断层冠脉血管造影 正电子发射计算机断层显像 13N-氨水 

分 类 号：R541.4[医药卫生—心血管疾病]