负荷心肌灌注显像、CT冠脉成像和冠脉造影对老年可疑冠心病人的诊断价值

Diagnostic value of ^(99)TCMIBI myocardial perfusion imaging,64-slice CT coronary angiography,coronary angiography in senile suspected patients with coronary artery disease

目的前瞻性比较50例可疑冠心病人。方法经PCI前后MECT、CAG和MPI三种检查方法的阳性率、冠脉狭窄程度和数量、缺血部位和再狭窄的特点。结果MECT与CAG示以中度狭窄较多,二者的阳性率、阴性率、轻中度狭窄的准确性基本一致,CAG在重度狭窄的准确性较高。三种方法PCI前后同等对照狭窄或缺血有显著差异,术前无差异,MPI阳性率低于前二者,可逆性缺血部位行PCI后缺血改善明显好于固定缺损区。再狭窄主要位于支架处,且为软化斑。结论MECT主要用于筛选可疑病人,了解斑块性质及PCI术后是否有再狭窄;MECT阳性者再行MPI了解缺血程度和部位;有可逆缺损者再行CAG和PCI。

Objective To compare twice the characteristics and differences of 64-slice CT coronary angiography(MECT),coronary angiography(CAG),myocardial perfusion imaging(MPI) respectively in suspected patients with coronary artery disease(CAD) before and after percutaneous intervention(PCI) prospectively.Methods MECT,CAG and MPI were performed respectively in 50 suspected senile patients with CAD before and after PCI.Degree and value of stenoses ,positive and negative rate,characteristics of restenoses were studied.Results Middle stenoses of coronary artery was significantly more than mild and severe stenoses,but positive and negative rate of stenoses was almost equal between MECT and CAG.PCI operated one year later,stenoses or ischemia founded by MECT,CAG and MPI significantly decreased than that before operation in the same class except lower positive rate for MPI,especially in the position of mild or reversible ischemia.Restenoses was almost malacoplakia and mainly distributed in the position of PCI. Conclusion MECT provides a faster screening of suspected patients with CAD,a direct and accuracy judgment of plaque and restenoses.For the reversible ischemia suspected patients with CAD found by MECT or MPI,CAG and PCI is the final and favorable choice.