心肌双核素显像三种图像处理方法诊断冠心病的临床价值  

Assessment of clinical value of three imaging process measures in double-nuclide myocardial SPECT imaging for diagnosing CHD

作　　者：张莉华[1] 谢文晖[1] 暐骏 

机构地区：[1]上海市胸科医院核医学科,200032

出　　处：《上海医学》2001年第9期570-572,共3页Shanghai Medical Journal

摘　　要：目的　比较心肌双核素断层图、原始图和定量靶心图 3种图像处理方法诊断冠心病 ,鉴别缺血心肌和缺血活性心肌。方法　设正常对照组 2 0例 ,冠脉造影证实冠状动脉有病变的患者 5 4例 ,其中冠状动脉狭窄 >5 0 %的冠心病患者 32例。在静息状态下静脉注射99mTc MIBI2 0mCi (740MBq) ,15min后作常规多巴酚丁胺负荷试验 ,在达到负荷要求时静脉注射 2 0 1Tl3mCi(111MBq)。分别在注射后 10min和 4h作心肌双核素断层图像采集 (SIEMENSSPECT仪器 )。结果　 (1) .心肌双核素断层图、原始图和定量靶心图诊断冠心病 (冠状动脉狭窄 >5 0 % )的灵敏度和特异性分别为 10 0 %、10 0 %、85 %和 98.5 %、73 .7%、78.9%。 (2 ) .断层图、原始图和定量靶心图诊断 72支冠状动脉病变 (冠脉造影异常 )的灵敏度和特异性分别为 5 4%、5 7.9%、47.2 %、和 96 .5 %、87.7%、92 .2 % (3) .断层图、原始图和定量靶心图诊断 32支冠状动脉狭窄 (狭窄 >5 0 % )的灵敏度和特异性分别为 75 %、78%、72 %、和 96 .5 %、87.7%、92 .2 %。结论　比较 3种图像处理方法 ,诊断冠心病和冠脉病变差异无显著性 (P >0 .0 5 )。但结合Objective To assess diagnosing value of 99m Tc MIBI/201TI double nuclide SPECT imaging, primary and quantified polar bulls eye plot for CHD. Methods Patients received intravenous injection of 99m Tc MIBI 740MBq(20mCi) in rest and 201TI 111MBq(3mCi) in stress test with dopa phenyltinamine. 99m Tc MIBI/201TI double nuclide SPECT imaging were perform in 10 min and 4 hr.(SIMENS SPECT, Energy Windows: 99m Tc 140Kev±15%,201TI 73Kev15%).There were 19 cases for normal group to set database and quantified polar bulls eye plot, and 54 cases of coronary artery disease defined by coronary artery angiography, including 32 cases of coronary artery stenosis >50%. Results 1).The sensitivity and specificity of diagnosis for CHD(stenosis>50%) with 99m Tc MIBI/201Tl double nuclide SPECT imaging, primary and quantified polar bulls eye plot, were 100%,100%,85% and 98.%,73.7%,78.9% respectively. Three methods showed no statics difference ( P >0.05). 2) The sensitivity and specificity of diagnosis for 72 abnormal coronary angiography with three methods were 54%, 57.9%, 47.2% and 96.5%, 87.7%, 92.2% respectively. There were no statistics difference ( P >0.05). 3). The sensitivity and specificity of diagnoses for 32 coronary artery stenosis(>50%) were 75%,78%,72% and 96.5%,87.7%,92.2% respectively ( P >0.05). Conclusion Comparing with three methods for diagnosis CHD and coronary artery disease had no significant difference. The quantified polar bulls eye plot after correction of normal database didn't improve the diagnosis accuracy of CHD and coronary disease. Combining three methods can improve the diagnosis reliability of CHD and differential diagnosis.

关 键 词：双核素心肌显像 显层-原始-校正靶心图 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病] R814.72[医药卫生—内科学]