左室腔与心肌计数比值对左室收缩功能异常的诊断价值

DIAGNOSTIC VALUE OF LEFT VENTRICULAR CAVITY-TO-MYOCARDIAL COUNT RATIO FOR ABNORMAL LEFT VENTRICULAR SYSTOLIC FUNCTION

目的评价应用９９ｍ锝－甲氧基异丁基异晴（９９ｍＴｃ－ＭＩＢＩ）心肌断层显像中左室腔与心肌计数（Ｃ／Ｍ）比值对左室收缩功能异常诊断的价值。方法对照组２７例、冠心病组３４例于１周内完成运动态和静息态９９ｍＴｃ－ＭＩＢＩ心肌断层显像及平衡法核素心室造影（ＥＲＮＡ），从短轴心肌断层图像中选取左室中部的心肌图像计算出Ｃ／Ｍ比值，利用ＥＲＮＡ测定左室射血分数（ＬＶＥＦ）。结果冠心病组运动态和静息态Ｃ／Ｍ比值均低于对照组（Ｐ＜０．００１），运动态和静息态Ｃ／Ｍ比值与ＬＶＥＦ正相关，ｒ分别为０．７２５９、０．６４８１，Ｐ均＜０．００１。运动态和静息态Ｃ／Ｍ比值诊断左室收缩功能异常的敏感性分别为７１．４％、６１．９％；特异性为９０．６％、９６．８％；准确性为８３．０％、８３．０％。结论９９ｍＴｃ－ＭＩＢＩ心肌断层显像中运动态和静息态Ｃ／Ｍ比值可作为诊断左室收缩功能异常的参考指标。

Objective To assess the diagnostic value of left ventricular cavity-to-myocardial count ratio (C/M ratio)in 99m Tc-MIBI myocardial SPECT studies for abnormal left ventricular systolic function.Methods 34 patients with coronary diseases (CAD) and 27 controls were subjected to 99m Tc-MIBI myocardial SPECT both at rest and exercise and to equilibrium radionuclinde ventriculography (ERNV) within 1 week. Both the exercise and rest C/M ratios were determined on short-axis tomograms. The LVEF was calculated from ERNV.Results Both the exercise and rest C/M ratios of CAD were lower than that of controls (P<0.001). There were positive correlations in LVEF with rest C/M ratio (r=0.6481,P<0.001) and exercise C/M ratio (r=0.7259,P<0.001). The sensitivity of exercise and rest C/M ratios for detecting abnormal left ventricular systolic function was 71.4% and 61.9%; the specificity was 90.6 % and 96.8%; the accuracy was 83.0%and 83.0% respectively.Conclusion Both exercise C/M ratio and rest C/M ratio may be useful in the evaluation of abnormal left systolic ventricular function.