摘要
目的探讨^(99)Tc^m-MIBI双嘧达莫负荷/静息门控心肌灌注显像心腔一过性缺血扩大(TID)比值的正常值及其对冠状动脉三支病变的诊断价值。方法 TID 比值正常上限是健康人群 TID比值平均数加2倍标准差(+2s)。健康组由67名患冠心病概率<5%的人群组成,患者组由112例可疑冠心病患者组成。所有受试者进行^(99)Tc^m-MIBI 双嘧达莫负荷/静息门控心肌灌注显像,患者组在显像后14 d 内接受冠状动脉血管造影。对心肌灌注图像进行定量分析,计算 TID 比值。结果 TID 的上限值为1.31。患者组中冠状动脉无明显狭窄者12例,其 TID 比值为1.07±0.21;冠状动脉单支狭窄者30例,其 TID 值为1.15±0.23;冠状动脉双支病变者28例,其 TID 比值为1.18±0.24;冠状动脉三支病变者42例,其 TID 比值为1.31±0.22。以1.31为 TID 比值的正常上限值,其发现冠状动脉三支病变冠心病的灵敏度和特异性分别为66.7%和98.4%。结论以1.31为 TID 比值的正常上限值,是发现同时具有三支冠状动脉病变冠心病的有效方法,是对心肌灌注显像目测分析法的有效补充。
Objective Patients with multivessel coronary artery disease may have normal myocardial perfusion images using SPECT. Transient ischemic dilation （TID） of the left ventricle （LV） is a marker for severe and extensive coronary artery disease（CAD）. The purpose of this study was to determine normal values of TID index in rest/dipyridamole pharmaceutical stress 99^Tc^m-MIBI gated SPECT myocardial perfusion imaging. Methods TID of 179 subjects was determined by a rest/dipyridamole pharmaceutical stress 99^Tc^m-MIBI SPECT myocardial perfusion imaging. The subjects had either 〈 5% likelihood of CAD （ n = 67） or coronary angiography in 14 d after SPECT imaging （ 12 = no CAD, 30 = single vessel CAD, 28 = two-vessel CAD, 42 = three-vessel CAD）. Emory Cardiac Toolbox （ECTb） quantitative software was used to calculate TID. The normal upper limit of TID index was defined as the mean value plus two standard deviations derived from another group of normal subjects. Results Using the normal upper limit of TID（ 1.31 ） as a criterion for abnormality yielded sensitivity and specificity of 45.0% and 91.7% for any CAD, 54.3% and 97.1% for two-vessel CAD, and 66.7% and 98.4% for three-vessel CAD. Conclusion Using the normal upper limit （TID = 1.31 ） as cut-off criteria for abnormality on patients with coronary angiography showed 66.7% sensitivity, and 98.4% specificity for three-vessel CAD.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2007年第3期168-170,共3页
Chinese Journal of Nuclear Medicine
