单光子发射计算机断层成像术心肌灌注显像联合冠状动脉CT血管成像诊断冠心病的临床应用  

Clinical Application of Single-photon Emission Computer Tomography Myocardial Infusion and Coronary Computed Tomography Angiography in Diagnosis of Coronary Heart Disease

作　　者：董小波[1] 张仲慧[1] 郭庆乐[2] DONG Xiaobo;ZHANG Zhonghui;GUO Qingle(Department of Nuclear Medicine,Kailuan General Hospital,Tangshan,Hebei 063000,China;CT Room,Kailuan General Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]开滦总医院核医学科,河北唐山063000 [2]开滦总医院CT室,河北唐山063000

出　　处：《岭南心血管病杂志》2023年第1期30-34,共5页South China Journal of Cardiovascular Diseases

基　　金：CTCA结合CT首过心肌灌注成像对冠心病诊断的应用价值(项目编号:20160746)。

摘　　要：目的 探讨单光子发射计算机断层成像术(single-photon emission computer tomography,SPECT)心肌灌注显像和冠状动脉计算机断层扫描(computed tomography,CT)血管成像技术(coronary CT angiography,CCTA)在冠状动脉粥样硬化性心脏病(冠心病)患者临床诊断中的有效性。方法 选取开滦总医院心血管内科2019年1月至2020年12月收治的经冠状动脉血管造影(coronary arteriongraphy,CAG)确诊的冠心病患者107例作为研究对象,均予以SPECT和CCTA检查,分析两者影像特征及诊断有效性。结果 以CAG为“金标准”,CCTA患者例数的敏感度、特异度、阳性预测值和阴性预测值分别为93.62%、80.00%、97.78%和35.29%,冠状动脉支数为97.68%、84.26%、97.15%和80.90%。SPECT患者例数的敏感度、特异度、阳性预测值和阴性预测值分别为92.86%、81.82%、97.85%和50.00%,冠状动脉支数分别为98.23%、84.26%、97.70%和85.06%。结论 在冠心病的临床诊断中,SPECT结合CCTA有效解决了CCTA特异度、阳性预测值低及伪影所致的漏诊现象,SPECT对CCTA诊断有较好的辅助作用,可互补以提高该病的诊断准确性。Objectives To investigate the effectiveness of single-photon emission computer tomography(SPECT)for myocardial perfusion imaging and coronary computed tomography(CT)angiography(CCTA)in the clinical diagnosis of myocardial ischemia in coronary heart disease.Methods Totally 107 patients with coronary heart disease diagnosed by coronary angiography(CAG)in the department of cardiovascular medicine of Kailuan General Hospital from January 2019 to December 2020 were selected as the research objects.They were examined by SPECT and CCTA to analyze their imaging characteristics and diagnostic effectiveness.Results Taking CAG as the gold standard,sensitivity,specificity,positive,and negative predictions were 93.62%,80.00%,97.78%,and 35.29%each for CCTA in number of patients;and 97.68%,84.26%,97.15%,and 80.90%each in number of coronary artery branches.Taking CAG as the gold standard,sensitivity,specificity,positive,and negative predictions for SPECT in number of patients were 92.86%,81.82%,97.85%,and 50.00%each;and 98.23%,84.26%,97.70%,and 85.06%each in number of coronary artery branches.Conclusions In the clinical diagnosis of coronary heart disease,SPECT combining CCTA can effectively solve the omission caused by low specificity,low positive predictive and artifact in CCTA.SPECT has a good auxiliary effect on CCTA diagnosis and is complementary to improve the diagnosis accuracy of the disease.

关 键 词：冠状动脉疾病 单光子发射计算机断层成像术 冠状动脉计算机断层扫描血管成像技术 

分 类 号：R541.4[医药卫生—心血管疾病]