摘要
【目的】对比研究超声二次谐波心肌声学造影与双核素心肌显像对心肌灌注的诊断价值。【方法】对 14例冠心病人和 6例可疑冠心病者进行冠脉造影 (CAG)、经静脉超声二次谐波心肌声学造影 (MCE)和双核素单光子发射计算机体层摄影术 (SPECT)心肌显像三项检查 ,共入选冠脉 6 0支和心肌区段 180个。MCE和SPECT以左心室 9段分法进行心肌灌注记分 ,以CAG结果为金标准进行MCE和SPECT的对比分析。【结果】对冠心病的诊断价值 :MCE和SPECT敏感性均为92 8% ,特异性分别为 83 3%和 6 6 7% ,阳性预测值分别为 92 8%和 86 7% ,阴性预测值分别为 83 3%和 80 0 % ,P均 >0 0 5。两种方法对左前降支、左回旋支病变检出的敏感性、特异性均较右冠状动脉高。根据冠脉狭窄程度将 6 0支冠脉分为 4组 ,各组之间MCE分值差异显著 ,狭窄程度越大 ,分值越小 ,P <0 0 5～ 0 0 0 1,同一组中 ,MCE与SPECT分值差异均无显著性。MCE分值与SPECT分值呈显著正相关 (r=0 78,P <0 0 1)。【结论】经静脉MCE与双核素SPECT均能有效地检出病变心肌范围和病变冠状动脉 ,两者对评价心肌灌注有很好的相关性。
To compare the diagnostic value of myocardial contrast echocardiography (MCE) with that of double nuclide myocardial single photon emission computed tomography (SPECT) for myocardial perfusion. Coronary angiography (CAG), intravenous MCE and double nuclide myocardial SPECT were performed in 20 patients, including 14 cases of coronary artery disease (CAD) and 6 cases of suspected CAD A total of 60 branches of coronary artery and 180 segments of myocardium were studied The estimation of MCE score and SPECT score was made by visual analysis from 9 segments model of left ventricular walls The Comparison of MCE and SPECT results was made, using CAG as the gold standard The sensitivity of MCE and SPECT for detecting CAD was 92 8%, and the specificity was 83 3% and 66 7% respectively The positive predictive value was 92 8% and 86 7% respectively The negative predictive value was 83 3% and 80 0% respectively, P>0 05 Sensitivity and specificity for detection of coronary heart disease related to left anterior descending branch and left circumflex branch were higher than that to right coronary artery All of the 60 coronary artery branches were classified as four groups. Significant differences in MCE score were found among the four groups The more severe the stenosis of the coronary artery by CAG , the lower the score of MCE, P<0 05～0 001 No significant differences in MCE and SPECT score were found in the same group MCE score was positively correlated with SPECT score(r=0 78, P<0 01).[Conclusion] Both intravenous MCE and double nuclide myocardial SPECT can effectively assess the extent of ischemia myocardial segment and detect the responsible vessel There is a good correlation between MCE and SPECT for evaluating myocardial perfusion
出处
《中山医科大学学报》
CAS
CSCD
北大核心
2002年第6期468-470,476,共4页
Academic Journal of Sun Yat-sen University of Medical Sciences
基金
深圳市医药卫生科技计划基金资助项目 (19980 60 0 1)
关键词
超声二次谐波心肌造影
双核素心肌显像
心肌灌注
冠心病
Coronary angiography
radionuclide ventriculography
tomography,emission computed,single photon
ultrasonography
coronary disease
myocardial reperfusion
