| 杨吉琴,李娟,平学军.腺苷负荷心肌灌注显像与双源CT冠状动脉造影诊断冠心病[J].中国医学影像技术,2011,27(12):2465~2468 |
| 腺苷负荷心肌灌注显像与双源CT冠状动脉造影诊断冠心病 |
| Adenosine stress myocardial perfusion imaging and dual-source computed tomography for detecting coronary heart disease |
| 投稿时间：2011-04-23 修订日期：2011-07-14 |
| DOI： |
| 中文关键词: 冠状动脉疾病 冠状血管造影术 心肌灌注显像 |
| 英文关键词:Coronary disease Coronary angiography Myocardial perfusion imaging |
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| 中文摘要: |
| 目的 探讨腺苷(ADE)负荷门控心肌灌注显像(G-MPI)与双源CT冠状动脉造影(DSCTCA)诊断冠状动脉病(CAD)的价值。方法 选择CAD可能性为低、中、高度的患者共53例,采用两日法行静息、腺苷负荷锝标记甲氧基异丁基异腈(99mTc-MIBI)G-MPI及DSCTCA,并于4周内进行CAG。采用美国心脏病协会17节段5分制(0~4分)目测半定量方法对MPI结果进行分析,静息与负荷评分的差值>1为可逆性缺血。DSCTCA结果采用目测直径法判断冠状动脉狭窄程度,分为:正常、狭窄<50%及狭窄程度≥50%。以CAG结果为"金标准",狭窄程度≥50%时定义为CAD,比较MPI和DSCTCA对CAD的诊断价值及两者之间的关系。结果 G-MPI和DSCTCA对CAD的诊断敏感度、特异度及准确率分别为94.44%(34/36)、52.94%(9/17)、81.13%(43/53)及88.89%(32/36)、88.24%(15/17)、88.68%(47/53)。两种检查方法差异有统计学意义(χ2=9.28,P=0.005)。结论 G-MPI和DSCTCA诊断CAD均有较高价值,联合应用可提供功能及解剖两方面的信息,提高对CAD的诊断效能。 |
| 英文摘要: |
| Objective To explore the value of adenosine (ADE) stress gated myocardial perfusion imaging (G-MPI) and dual-source CT coronary angiography (DSCTCA) in diagnosis of coronary artery disease (CAD). Methods Fifty-three patients with low, medium and high probability of CAD underwent resting (REST), ADE stress G- MPI and DSCTCA, then they underwent CAG within 4 weeks. MPI results were analyzed using the American Heart Association 17 segment 5-point scale (0-4 points) visual semi-quantitative method, and the resting and stress rating of the difference >1 were identified as reversible defect. Coronary stenosis were determined using international common law of DSCTCA visual diameter and were divided into normal and stenosis <50% or ≥50%. Taking CAG results as gold standards and stenosis ≥50% defined as CAD, diagnostic value of MPI and DSCTCA was compared. Results According to CAG results, the sensitivity, specificity and accuracy of G-MPI and DSCTCA in diagnosis of CAD was 94.44% (34/36), 52.94% (9/17), 81.13% (43/53) and 88.89% (32/36), 88.24% (15/17), 88.68% (47/53), respectively (χ2=9.28, P=0.005). Conclusion G-MPI and DSCTCA both have high value in diagnosis of CAD, combination of these two methods can improve the diagnostic utility of CAD through obtaining both functional and anatomical information. |
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