摘要
目的:回顾性分析60例病人冠状动脉造影(CAG)和心肌灌注显像(MPI)结果不一致的资料。方法:所有 MPI检查用Toshiba GCA-7100A/D型 SPECT仪完成。以CAG结果示冠状动脉狭窄≥50%为有临床意义的冠状动脉狭窄。结果:60例中CAG结果和MPI结果不符合者15例(25%)。15例病人平均年龄52.7±9.5岁,男11例,女4例。MPI显示心肌缺血而CAG正常者9例,其中临床诊断X综合征3例、陈旧性心肌梗塞1例、心绞痛(冠状动脉狭窄30%~40%)3例、高血压病2例;MPI显示正常而CAG有临床意义狭窄6例(狭窄50%~60%者6例次,累及右冠状动脉者3例次,分支狭窄者3例次,伴良好侧枝循环2例次)。结论:心肌灌注断层显像不正常而CAG正常者,不能认为显像均为假阳性,其中有78%的MPI诊断与临床诊断符合;心肌显像阴性、CAG证实狭窄≥50%,大部分为冠状动脉远端分支狭窄和临界性冠状动脉狭窄及右冠状动脉狭窄。
Objectives: To analyze the unconformable results between myocardial perfusion SPECT and coronary angiography (CAG). Methods: The data of 60 in - patients who underwent myocardial perfusion SPECT and CAG were analyzed. Results: Among them, 15 patients,11 males and 4 females (average age 52.7 ±9.5 years old), had unconformable results of SPELT and CAG. Group A included 9 cases with myocardial ischemia on SPECT and normal coronary artery or coronary stenosis<50% on CAG, which were one case of old myocardial infarction, 3 cases of X syndrome, 3 cases with 30% - 40% coronary stenosis, 2 cases of essential hypertension. Group B included 6 cases with cases with normal SPECT and coronary stenosis≥50% on CAG.There were 6 cases with coronary artery stenosis between 50% - 60%, 3 right coronary artery stenosis, 3 terminal branches stenosis, 2 collateral circulation. Conclusions: It can not be considered that all abnormal SPECT without significant coronary stronary is false positive; while most of normal SPECT with significant coronary stenosis indicate terminal branch stenosis,coronaly stenosis between 50%- 60% on right coronary artery stenosis.
出处
《重庆医学》
CAS
CSCD
2000年第1期11-12,共2页
Chongqing medicine
关键词
冠心病
心肌灌注显像
冠状动脉造影
Coronary artery disease Coronary angiography Tomography Emission computer Single photon