腺苷负荷-静息门控心肌灌注显像对冠心病三支病变患者的诊断价值  

Diagnostic Value of Adenosine Stress-resting Gated Myocardial Perfusion Imaging in the Diagnosis of Three-vessel Coronary Heart Disease

作　　者：洪丽菊 吴飞鹏 吴琪燕 郑贤东 杨蕊[1] 陈丹丹 周友俊[1] HONG Liju;WU Feipeng;WU Qiyan;ZHENG Xiandong;YANG Rui;CHEN Dandan;ZHOU Youjun(Department of Nuclear Medicine,Yan’an Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650051,China)

机构地区：[1]昆明医科大学附属延安医院核医学科,云南昆明650051

出　　处：《昆明医科大学学报》2025年第3期124-131,共8页Journal of Kunming Medical University

基　　金：春城计划“春城名医”专项基金(C202012021);昆明市卫生科技人才培养基金(2020SW-24);昆明市卫生科技人才培养基金(2023SW-20);兴滇英才支持计划“名医专项”基金(XDYC-MY-2022-0108);云南省科技厅-昆明医科大学基础研究联合专项基金(202401AY070001-191)。

摘　　要：目的 评价腺苷负荷-静息门控心肌灌注显像对冠心病三支病变的诊断价值。方法 回顾性纳入2021年1月至2022年12月于昆明医科大学附属延安医院行冠脉造影并确诊为冠心病的患者318例,根据冠脉造影结果,将318例冠心病患者分为三支病变组166例与非三支病变组(单支与双支病变组)152例,所有入组对象于两周内行腺苷负荷-静息GMPI,收集患者的腺苷负荷-静息GMPI心肌灌注参数(SSS、SRS、SDS)、心功能参数(LVEF、LVEDV、LVESV)、左心室机械收缩同步性参数(PSD、PHB)等。探讨腺苷负荷-静息门控心肌灌注显像对冠心病三支病变的诊断价值。结果 灌注参数中SSS具有最高的AUC为0.781,心功能参数中sLVEF具有最高的AUC为0.748,同步性参数中sPHB具有最高的AUC为0.724;联合参数的AUC均高于灌注参数、心功能参数及同步性参数(P均<0.05)。比较三支病变组与非三支病变组负荷较静息的变化值:三支病变组与非三支病变组ΔLVESV、ΔLVEF存在统计学差异(P <0.05)。结论 腺苷负荷-静息门控心肌灌注显像灌注、心功能及同步性参数均对冠心病三支病变具有较高诊断价值,三种参数联合检测对冠心病三支病变诊断具有更高的价值。Objective To evaluate the diagnostic value of adenosine load-resting gated myocardial perfusion imaging for three-vessel disease in coronary artery disease(CAD)patients using coronary angiography as the gold standard.Methods A retrospective study was conducted,including 318 patients diagnosed with CAD who underwent coronary angiography at Yanan Hospital Affiliated to Kunming Medical University from January 2021 to December 2022.Based on the results of coronary angiography,the 318 CAD patients were divided into a three-vessel disease group(n=166)and a non-three-vessel disease group(single and double vessel disease group,n=152).All the subjects underwent adenosine stress-resting GMPI within two weeks.Adenosine stress-resting GMPI myocardial perfusion parameters(SSS,SRS,SDS),cardiac function parameters(LVEF,LVEDV,LVSV)and left ventricular mechanical contraction synchronization parameters(PSD,PHB)were collected.The diagnostic value of adenosine stress-resting gated myocardial perfusion imaging for three-vessel disease in CAD was explored.Results Among the perfusion parameters,SSS had the highest AUC of 0.781,while sLVEF had the highest AUC of 0.748 among cardiac function parameters,and sPHB had the highest AUC of 0.724 among synchrony parameters.The AUCs of combined parameters were all higher than those of perfusion parameters,cardiac function parameters,and synchrony parameters(P<0.05).The changes inΔLVESV andΔLVEF between the three-vessel disease group and the non-three vessel disease group showed statistical significance(P<0.05).Conclusion The perfusion,cardiac function and synchronization parameters of adenosine stress-resting gated myocardial perfusion imaging have high diagnostic value for three-vessel coronary heart disease,and the combined detection of the three parameters provides even greater diagnostic value for three-vessel coronary heart disease.

关 键 词：腺苷 负荷门控心肌灌注显像 冠心病 三支病变 

分 类 号：R817.4[医药卫生—影像医学与核医学]