核素心肌灌注显像与电子束CT诊断冠心病的对比研究

A comparative study of ^(99m)TcMIBI SPECT and EBCT in diagnosis of coronary heart disease

目的比较核素心肌ＳＰＥＣＴ显像与电子束ＣＴ（ＥＢＣＴ）扫描对冠心病（ＣＨＤ）的诊断价值。方法对６４例受检者（ＣＨＤ患者５０例，非ＣＨＤ患者１４例）进行了冠状动脉造影、ＳＰＥＣＴ及ＥＢＣＴ检查。结果以冠状动脉造影为金标准，ＳＰＥＣＴ与ＥＢＣＴ诊断ＣＨＤ的灵敏度相近，分别为９２０％和９４０％；ＳＰＥＣＴ的特异性（９２９％）优于ＥＢＣＴ（２８６％），Ｐ＜００５。在判断ＥＢＣＴ结果时，采用不同的钙化积分阈值，对诊断ＣＨＤ的灵敏度和特异性影响很大，故应采用接收器工作特性分析确定适当的钙化积分阈值。结论ＥＢＣＴ虽具有一定优越性，但目前尚不能取代心肌ＳＰＥＣＴ显像。

Purpose To comparatively study ^(99m)TcMIBI SPECT and electron beam CT (EBCT) in diagnosing coronary heart disease (CHD) Methods 64 patients (54 men, 10 women; mean age 59.7years) underwent SPECT, EBCT and cononary arteriography within one month Results Using coronary arteriographic findings as gold standard, the sensitivities of SPECT and EBCT for diagnosing CHD were 92.0% and 94.0%, the specificities were 92.9% and 28.6%, respectively The sensitivity and specificity of EBCT for diagnosing CHD were varying with different threshold limits used for coronary calcification scoring Receiver operating characteristic analysis should be used to define the appropriate threshold limit for coronary calcification scoring Conclusions EBCT is of some advantages, but should not be used in place of SPECT in diagnosis of CHD