静息^(99m)Tc-MIBI心肌灌注断层显像诊断男性冠心病价值评估

Evaluation of rest ^(99m)Tc-MIBI myocardial perfusion SPECT in diagnosing male CAD

目的:研究静息99mTc-MIBI心肌灌注单光子发射计算机断层显像(SPECT)对男性冠心病的诊断价值。方法:以选择性冠状动脉造影术(CAG)为对照,将57例男性患者分为冠心病组(33例)及非冠心病组(24例),计算SPECT的各项评价指标,继而结合临床诊断将冠心病组分为心肌梗塞组(18例)及心绞痛组(15例),比较两组SPECT阳性率差异。结果:静息SPECT诊断男性冠心病灵敏度为87.88%,特异度为70.83%,准确度为80.70%,阴性预测值为80.95%,提示SPECT对男性冠心病检出率、符合率较高,而阴性对排除冠心病有较高的价值,心肌梗塞组阳性率为100%(18/18),心绞痛组为73.33%(11/15),提示静息SPECT检出男性心肌梗塞的阳性率高于心绞痛。结论:结合实验结果及SPECT具有无创、价廉、可重复等特点,SPECT可作为诊断男性冠心病的初筛检查。

Objective:To explore the value of rest 99mTc MIBI myocardial perfusion SPECT in diagnosing male coronary artery disease(CAD).Methods:Based on coronary angiography(CAG) and clinical diagnosis,57 patients were classified as CAD group(33 cases) and non CAD group(24 cases)which include 15 cases without organic heart problems and 9 cases of other heart diseases.Several diagnosing indexes of SPECT were calculated and positive rates of SPECT in diagnosing MI and angina were compared.Results:Sensitivity and specificity of SPECT were 87 88%and 70 83%,respectively.Accuracy was 80 70%and negative predictive value was 80 95%,so it suggests that SPECT has a higher positive rate and coincidence rate in male CAD.When in negative result,it has important value in excluding CAD In myocardium infarction and pectoralis angina group.The positive rate were 100%(18/18)and 73 33%(11/15) respectively.Conclusion:According to examination and SPECT result,SPECT can be used as a screening method for male CAD due to its noninvasiveness,low cost and the ability to be used repeatedly.