^(99m)Tc-MIBI门控心肌舒张末期影像与非门控心肌影像检测老年冠心病人的比较

Comparison between the end-diastolic images of gated and the Non gated images with ^(99m)Tc-MIBI perfusion in detection of the elderly patients with coronary artery disease

目的 评价 99m Tc- MIBI门控心肌舒张末期影像 (EDI)与非门控心肌影像 (NGI)对检测老年人冠心病的实际应用价值。方法 对 58例己确诊和可疑冠心病患者 (47例有冠脉造影 )进行了 99m Tc- MIBI门控心肌灌注断层显像 ,并比较了门控舒张末期影像 (EDI)与非门控心肌影像(NGI)检测冠心病的诊断效能和一致性。结果 EDI和 NGI检测冠心病的灵敏度分别为 84.84% (2 8/ 33)和 72 .72 % (2 4 / 33)。 5例冠心病患者中有4例 NGI未检出异常而 EDI发现有缺血。 EDI特异性为 85.71 % (1 2 / 1 4 ) ,NGI为 78.57% (1 1 / 1 4 )。总共检测 2 90个节段中 ,NGI检出 50个节段有心肌缺血 ,EDI为 83个节段 (P<0 .0 5)。两种方法间检测心肌节段异常的一致性为 85.1 7% (2 4 7/ 2 90 )。 EDI显示出比 NGI能检出更多的心肌缺血。结论 99m Tc- MIBI电路控制心肌灌注断层显像的

? Objective To evaluate the clinical value of the end diastolic images(EDI)of gated and the non gated inages(NGI) with 99m Tc MIBI perfusion in detecting elderly patients with coronary artery disease(CAD).Methods Exercises and rest 99m Tc MIBI gated single photon emission computed tomography(SPECT) were performed on 58 patients with known or suspected CAD(47 underwent coronary angiography) and the diagnostic efficency and agreement of detecting coronary artery disease(CAD) were compared between EDI and NGI with 99m Tc MIBI perfusion study.Results The sensitivity was 84 84%(28/33) and 72 72%(24/33) for EDI and NGI,respectively.4 of 5 patients with CAD were not detected by NGI but seen with EDI.The specificity was 78 57%(11/14) and 85 71%(12/14) for NGI and EDI,respectively.Of a total of 290 segments,50 ischemic defects were detected by NGI and 83 by EDI( P <0 05).The segmental agreement between the two techniques was 85 17%(247/290 segments).EDI showed more ischemic defects than NGI.Conclusions EDI may be a useful technology to detect elderly patients with coronary artery disease in such a clinical situation. 〔