^(99)mTc-MIBI门控心肌灌注断层显像检测冠心病的准确性

Accuracy of ^(99m)Tc-MIBI gated myocardial perfusion tomograpohy in detection of coronary artery disease

目的 评价 99m Tc- MIBI门控心肌灌注断层显像估价冠心病 (CAD)的准确性 ,以及门控心肌灌注断层显像显示心肌损害与冠脉造影的关系。方法 对 93例受检者进行了运动 /静息 99m Tc- MIBI门控心肌灌注断层显像 ,其中 47例有冠脉造影检查 ,冠状动脉狭窄 >50 %为 CAD诊断标准。结果 检测 CAD的灵敏度为 84.84% ,特异性为 85.71 % ,准确性为 92 .0 0 %。正常人组的正常符合率 94%。检测 LAD病变的灵敏度为84.62 % ,LCX为 77.77% ,RCA为 85.71 %。检测 L AD病变的准确性 79% ,LCX为 77% ,RCA为 82 %。 1 2例冠脉造影显示 50 %～ 70 %狭窄者与心肌灌注显像的相关性较差 (r=0 .33,P=NS)。 2 1例冠脉造影显示 >70 %狭窄者与心肌灌注显像有良好的相关性 (r=0 .0 5,P<0 .0 5)。结论 99m Tc-MIBI门控心肌灌注断层显像可以准确地检测冠心病 ,在避免冠脉造影检查风险方面 。

? Objective To evaluate the accuracy of 99m Tc MIBI gated myocardial perfusion tomography in detection of coronary artery disease(CAD) and the relation between the severity of impaired gated myocardial perfusion tomography and the angiographic coronary artery stenosis in the patients with CAD.Methods Exercise and rest 99m Tc MIBI gated myocardial perfusion tomography were performed on 58 patients with suspected or known coronary artery disease and 35 normal controls,47 of whom underwent coronary angiography and significant disease was defined by >50% luminal coronary artery stenosis.Results The sensitivity was 84 84%,specificity was 85 71% and accuracy was 92% for detecting CAD,respectively.The normalcy rate for the normal controls was 94%.The sensitivity was 84 62% for LAD,77 77% for LCX,and 85 71% for RCA.The accuracy was 79% for LAD,77% for LCX,and 82% for RCA.In 12 patients with 50～70% luminal coronary artery stenosis,linear regression analysis between myocardial perfusion imaging and coronary angiography showed a poor correlation(r=0 33,P=NS).In 21 patients with >70% luminal coronary artery stenosis,there is a significant correlation between myocardial perfusion imaging and coronary angiography(r=0 55,P<0 05).Conclusions This study shows that 99m Tc MIBI gated myocardial perfusion tomograohy can detect coronary artery disease accurately.It is more valuable for elder patients with CAD. 〔