^(123)I-BMIPP心肌断层显像对劳力性心绞痛的诊断价值

Diagnostic value of myocardial tomographic imaging with 123 I labeled BMIPP for exerciseinduced angina pectoris

目的探讨安静时１２３Ｉβ甲基碘苯脂十五烷酸（ＢＭＩＰＰ）心肌断层显像（简称１２３ＩＢＭＩＰＰＳＰＥＣＴ）对劳力性心绞痛的诊断价值，并与运动负荷２０１Ｔｌ心肌断层显像（简称２０１ＴｌＳＰＥＣＴ）对比分析。方法对３２例劳力性心绞痛患者及１２例健康对照者进行１２３ＩＢＭＩＰＰＳＰＥＣＴ及２０１ＴｌＳＰＥＣＴ检查；将左室划分为９个节段，采用４级评分法对各节段放射性分布进行半定量评价（ＤＳ）。结果心绞痛组２０１ＴｌＳＰＥＣＴ表现为放射性分布低下的节段大于１２３ＩＢＭＩＰＰＳＰＥＣＴ，二者ＤＳ的一致率为６０８％。１２３ＩＢＭＩＰＰＳＰＥＣＴ检出冠状动脉狭窄病变的敏感性、特异性及准确性分别为６２％、９２％、７０％，２０１ＴｌＳＰＥＣＴ为８４％、８３％、８４％，１２３ＩＢＭＩＰＰＳＰＥＣＴ的敏感性明显低于２０１ＴｌＳＰＥＣＴ（Ｐ＜００５）。冠状动脉狭窄支数越多，病变程度越重，１２３ＩＢＭＩＰＰＳＰＥＣＴ的检出率越高。结论安静时１２３ＩＢＭＩＰＰＳＰＥＣＴ对劳力性心绞痛冠状动脉狭窄的检出及其程度的判定有一定的临床价值。

Objective To evaluate the diagnostic value of resting myocardial tomographic imaging with 123 I labelled BMIPP (123IBMIPP SPECT) for exerciseinduced angina pectoris by comparison with stress myocardial tomographic imaging with 201 Tl (201Tl SPECT) Methods 123IBMIPP SPECT and 201 Tl SPECT were performed in 32 patients with exerciseinduced angina pectoris and 12 normal controls Left ventricle was divided into nine segments and uptake of 201 Tl and 123 IBMIPP was evaluated by four classes score method (defect score, DS) Results In the patients with angina pectoris, segments of 201 Tl distribution abnormality were more than that of 123 IBMIPP Concordant rate between DS of the 201 Tl SPECT and that of the 123*8/9IBMIPP SPECT was 608% Sensitivity, specificity and accuracy of 123 IBMIPP SPECT for detecting coronary artery stenosis were 62%, 92% and 70%, respectively, and 201G*8/9Tl SPECT were 84%, 83% and 84%, respectively Sensitivity of 123 IBMIPP SPECT was significantly lower than that of 201 Tl SPECT ( P <005) The more branches of coronary artery stenosed, the more serious the degree of stenosis, the higher positive rate of 123KG*8/9IBMIPP SPECT will be Conclusions The results indicated that to a certain extent, resting 123 IBMIPP SPECT may has practical clinical value for detection of coronary artery stenosis, and determination of stenotic degree in the patients with exerciseinduced angina pectoris