腺苷负荷试验心肌核素显像对冠心病的诊断价值

The application of adenosine stress myocardial perfusion tomographie imaging in detecting coronary artery disease

目的分析腺苷负荷试验心肌核素显像诊断冠心病的敏感性、特异性及其特点。方法住院患者行冠状动脉造影和腺苷负荷试验心肌核素显像检查。腺苷总量为140μg/(kg·min),6min匀速静脉泵入,腺苷泵入3min时静脉推注99m锝-甲氧基异丁基异腈核素显像925MBq,1h后进行心肌断层显像,若异常,次日行静息心肌显像。结果腺苷负荷试验心肌核素显像对于冠心病诊断的敏感性和特异性为87.0%和64.2%。前降支病变48例,心肌核素前壁低灌注41例,回旋支病变33例,侧壁低灌注27例,右冠脉病变38例,下壁低灌注37例,右冠脉病变较前降支或回旋支病变的心肌核素显像阳性率高(P<0.05)。结论腺苷负荷试验心肌核素显像对于冠心病诊断的敏感性、特异性较高。

Objective To analyze the sensitivity and specificity of adenosine stress myocardial perfusion tomographic imaging for the diagnosis of coronary artery disease （CAD）. Methods Adenosine was infused intravenously at a rate of 140μg/ （kg·min） for 6 minutes. 3 minutes after adenosine infusion,925MBq of 99mTc-MIBI were injected intravenously. SPECT myocardial imaging acquisition was obtained 1 hours after adenosine infusion. If the result was abnormal rest myocardial perfusion imaging would be performed next day. Results The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 87.0% and 64.2%. The sensitivity of adenosine myocardial perfusion tomographic imaging for diagnosing coronary stenosis in left anterior descending,left circumflex and right coronary artery are 41/48,27/33 and 37/38. There was no severe adverse side effect during adenosine stress test. Conclusion Adenosine stress myocardial perfusion tomographic imaging is an useful non-interventional method for detecting coronary artery disease.