摘要
目的：探讨64排螺旋CT冠状动脉造影（CT angiography，CTA）诊断冠脉狭窄的程度与单光子发射计算机断层扫描（single photon emission computed tomography，SPECT）心肌灌注显像（myocadiac perfusion imaging，MPI）诊断相关狭窄动脉所支配的心肌血流灌注状况之间的对应关系。方法：112例可疑冠心病的胸痛患者在1周内均行CTA及^99mTc-MIBI（甲氧基异丁基异腈）MPI。比较不同狭窄程度的冠脉与相关狭窄动脉所支配的心肌血流灌注之间的关系。结果：分别以冠脉狭窄≥50％及〉170％为诊断心肌缺血的阳性标准。以患者作为比较对象，CTA预测心肌缺血的敏感性、特异性、阳性预测值、阴性预测值分别为88％，52％，74％，74％和76％，86％，90％，70％；以病变血管作为比较，CTA预测心肌缺血的敏感性、特异性、阳性预测值、阴性预测值分别为92％，73％，66％，94％和47％，94％，82％，76％。结论：CTA诊断的冠脉狭窄程度≥70％时与相应的MPI显示心肌缺血之间的一致性较高，而狭窄在50％～70％的患者中两者的结果差异较大。
Objective： To evaluate spiral multidetector computed tomography（MDCT） angiography using 64-slice technique in the detection of functionally relevant coronary artery stenoses（CAS）. Methods： One hundred and twelve patients with suspected coronary artery disease were investigated using 64-slice MDCT angiography and myocardial perfusion imaging with ^99mTc-MIBI -SPECT within one week. Stenoses with luminal narrowing of ≥50% were defined as ＂significant＂ in MDCT. MDCT angiography was compared with the detection of functionally relevant CAS. Results： In patient-based analysis, stenoses with luminal narrowing of ≥50% were defined as ＂significant＂ in MDCT,then the sensitivity, specificity,positive and negative predictive values of MDCT angiography in detecting reversible perfusion defects on SPECT were 88%, 52% , 74% and 74% ;Respectively, stenoses with luminal narrowing of 〉170% were defined as ＂significant＂ in MDCT,then the sensitivity, specificity,positive and negative predictive values of MDCT angiography in detecting reversible perfusion defects on SPECT were 76% , 86%, 90% and 70%. In vesselbased analysis, stenoses with luminal narrowing of I〉50% were defined as ＂significant＂ in M DCT,then the sensitivity, specificity, positive and negative predictive values of MDCT angiography in detecting reversible perfusion defects on SPECT were 92%, 73%, 66% and 94%, respectively, stenoses with luminal narrowing of ≥70% were defined as ＂significant＂ in MDCT, then the sensitivity, specificity, positive and negative predictive values of MDCT angiography in detecting reversible perfusion defects on SPECT were 47%, 94% , 82% and 76%. Conclusion： There was good correlation between MPI and CTA for the detection of functionally significant coronary artery stenoses when CTA detected a narrowing of ≥70% severity. CTA stenoses of 70% should be used to determine functional significance, and not 50%, as is the usual practice at present.
出处
《江苏大学学报（医学版）》
CAS
2008年第6期522-524,共3页
Journal of Jiangsu University：Medicine Edition
关键词
心肌灌注显像
64排螺旋CT
冠心病
myocardial perfusion imaging
64-slice CT angiography
coronary artery disease
