^(99m)锝单光子发射计算机断层心肌显像与冠状动脉数字减影血管造影对冠心病的诊断价值比较  

The diagnosis of coronary heart disease with ^(99m)TC compared with DSA

作　　者：杨中 汪世存 凌华毓 YANG Zhong;WANG Shicun;LING Huayu(Department of Nuclear Medicine,BOE Hospital,Hefei,Anhui 230012,China;Department of Nuclear Medicine,The First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China;Department of Nuclear Medicine,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215004,China)

机构地区：[1]合肥京东方医院核医学科,安徽合肥230012 [2]中国科技大学附属第一医院(安徽省立医院)核医学科,安徽合肥230001 [3]苏州大学附属第二医院核医学科,江苏苏州215004

出　　处：《安徽医药》2021年第5期917-919,I0001,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的比较^(^(99m))锝(^(99m)TC)单光子发射计算机断层成像术(SPECT)心肌显像与冠状动脉数字减影血管造影(DSA)诊断冠心病(CHD)的价值,探讨诊断心肌缺血与心肌梗死的有效途径。方法选取2016年1月至2019年1月第一作者在安庆市立医院工作及安徽省立医院进修期间临床拟诊为冠心病进行诊治的108例病人中抽出做过冠脉造影(CAG)的病人13例,均行^(99m)TC SPECT心肌运动负荷灌注显像,次日(24 h后)负荷显像诊断为阳性的12例行^(99m)TC SPECT心肌静息灌注显像。结果确诊的13例冠心病中5例为心肌梗死,5例为心肌缺血,1例为X综合征,2例正常。CAG诊断结果,5例为心肌梗死,5例为心肌缺血,3例正常。运动负荷心肌显像诊断结果,心肌缺血12例,1例正常;诊断为心肌缺血的12例做了静息心肌显像,结果静息+运动心肌显像诊断6例为心肌梗死,6例为心肌缺血,1例正常。SPECT显像诊断1例为假阳性,1例假阴性,CAG诊断2例假阴性,1例假阳性。SPECT阳性率为92.3%,CAG为76.9%;SPECT准确率为84.6%,CAG为76.9%。结论^(99m)TC SPECT心肌显像与CAG对照诊断,重点分析不同,优势互补,综合评估,冠心病的诊断准确率大大提高,两者对比诊断有很高的临床应用价值。Objective Compare the value of^(99m)TC single photon emission computed tomography(SPECT)myocardial imaging and coronary digital subtraction angiography(DSA)in diagnosing coronary heart disease(CHD),and explore effective ways to diagnose myocardial ischemia and myocardial infarction.Methods From January 2016 to January 2019,among 108 patients to be diagnosed and treated for coronary heart disease,13 patients who had undergone coronary angiography(CAG)were selected retrospectively,all of whom received myocardial perfusion imaging received resting myocardial perfusion imaging,while 1 patients who were diagnosed as negative did not receive resting myocardial perfusion imaging.Results ^(99m)TC SPECT myocardial resting and exercise load imaging can directly show the azimuth-area size and degree of myocardial ischemia.It has very special clinical significance in the risk assessment and post-treatment evaluation of coronary heart disease,but there are also many factors causing false positive or false negative.Although DSA is the gold standard for coronary artery examination,it can’t reflect the stenosis of very small coronary vessels,so both of them have certain advantages and disadvantages.In this study,the inconsistencies were identified,and combined with a variety of clinical data,the accuracy of the diagnosis of coronary heart disease were significantly improved.Conclusion The comparative diagnosis of^(99m)TC SPECT myocardial imaging,and focus on differences,coronary angiography results is complementary,comprehensive evaluation,the diagnosis accuracy of coronary heart disease is greatly improved,and the comparative diagnosis of the two has high clinical application value.

关 键 词：冠心病 单光子发射计算机断层成像 数字减影血管造影 

分 类 号：R541.4[医药卫生—心血管疾病]