^(99m)Tc-MIBI心肌灌注显像与电子束CT诊断冠心病的临床评价  

CLINICAL EVALUATION OF MYOCARDIAL PERFUSION IMAGING WITH TECHNETIUM-99~M SESTAMIBI SPECT AND EBCT IN PATIENTS WITH CORONARY ARTERY DISEASE

作　　者：朱军[1] 施海明[1] 田东 罗心平[1] 范维琥[1] 王受益[1] 戴瑞鸿[1] 

机构地区：[1]上海医科大学附属华山医院心内科,200040 [2]山东省菏泽市人民医院

出　　处：《中国现代医学杂志》2000年第10期7-8,11,共3页China Journal of Modern Medicine

摘　　要：目的 :评价99mTc -MIBI心肌灌注显像及电子束CT诊断冠心病的临床价值。方法 :6 2例患者在CAG检查 2周内行99mTc-MIBI心肌灌注显像及EBCT冠脉钙化扫描。采用敏感性、特异性、阳性预测值、阴性预测值及准确度等指标对EBCT及SPECT的结果进行评价。结果 :单独使用SPECT心肌灌注显像诊断冠心病的敏感性为 93% ,特异性为 33% ,准确性为 6 1%。在选取不同冠脉钙化积分 (CCS)临界值时 ,所得诊断冠心病的敏感性为 45 %～ 93 % ,特异性为 30 %～ 94% ,准确性为 6 0 %～ 84%。取 10分为临界值时 ,两种方法采用平行联合试验所得诊断冠心病的敏感性和阴性预测值分别为 97%和 89% ;采用系列联合试验诊断冠心病的特异度、阳性预测值分别为 91%和 89%。结论 :SPECT心肌灌注显像及心脏EBCT冠脉钙化积分测定对冠心病的诊断均有一定的临床价值 ,两者联合应用对临床诊断冠心病更具帮助。Objective: To evaluate the clinical value of technetium- 99m methoxyisobutylisonitrile (MIBI) myocardial perfusion single-photon emission computed tomography (SPECT) and electron beam computed tomography (EBCT) in the detection of coronary artery disease (CAD). Methods: 99m Tc-MIBI SPECT (stress-resting) and EBCT studies were performed in 62 patients with suspected CAD who underwent coronary angiography (CAG). Results: The sensitivity of SPECT in detecting CAD in 62 patients was 93%, specificity was 32%, accuracy was 61%. At different cutoff points of CCS, the sensitivity of EBCT in detecting CAD was 93%～45%, specificity was 30%～94%, accuracy was 60%～84%. At ten of CCS, the sensitivity and negative predictive value of combination of EBCT and SPECT in parallel test was 97% and 89%; the specificity and positive predictive value in serial test was 91% and 89%. Conclusions: 99m Tc-MIBI myocardial perfusion SPECT and EBCT provide different information in the assessment of CAD. More reliable results will be obtained if both myocardial perfusion SPET and EBCT are performed.

关 键 词：电子束CT 心肌灌注显像 冠心病 诊断 锝99M-MIBI 

分 类 号：R541.404[医药卫生—心血管疾病]