潘生丁^（99m）Tc－MIBI心肌灌注显像对冠心病诊断价值的研究

DIPYRIDAMOLE 99m Tc-MIBI MYOCARDIAL IMAGING FOR THE DIAGNOSIS OF CORONARY ARTERY DISEASE

目的探讨ＤＰ９９ｍＴｃ－ＭＩＢＩ心肌灌注显像在冠心病诊断中的应用价值。材料和方法应用新型９９ｍＴｃ－标记异腈类心肌灌注显像剂９９ｍＴｃ－甲氧基异腈（９９ｍＴｃ－ＭＩＢＩ），结合潘生丁（ＤＰ）试验，对１６名陈旧性心肌梗塞患者、１７名冠心病心绞痛患者及９名正常对照者进行了平面心肌灌注显像检查，并与心电图改变加以对比研究。结果在１６名陈旧性心肌梗塞患者中，有１５例（９３．８％）表现为固定性缺损，其中６例（３７．５％）同时合并有可逆性缺损。１７例心绞痛患者中，共检出可逆性缺损１４例，２例合并有固定性缺损，１例单独表现为固定性缺损。９９ｍＴｃ－ＭＩＢＩ心肌显像对冠心病诊断的敏感性为９０．９％，特异性为８８．８％。结论潘生丁９９ｍＴｃ－ＭＩＢＩ心肌灌注显像对于冠心病的诊断较心电图具有更全面的临床实用价值。

Objective:To evaluate the diagnostic value of Dipyridamole 99m Tc-MIBI myocardial perfusion imaging for detecting coronary artery disease (CAD).Methods:16 patients with old myocardial infarction,17 patients with angina pectoris and 9 normal controls were studied using Dipyridamole 99m Tc-MIBI myocardial perfusion imaging and the results were compared with those of electrocardiographic examination.Results:15 of 16 (93.8%) patients with old myocardial infarction showed fixed defects.Among them 6 patrents (37.5%) revealed reversible defects.In angina group, 14(82.4%) had reversible defects,2 accompanied by fixed defects ,and one had fixed defect only.Overal sensitivity and specificity of 99m Tc-MIBI myocardial perfusion for the diagnosis of CAD were 90.9% and 88.8%,respectively.Conclusion: 99m Tc-MIBI myocardial imaging is superior to ECG testing in detecting CAD.