核素心肌灌注显像对冠状动脉慢性完全闭塞病变诊断的评价

Review on diagnosis of chronic coronary total occlusion with radionuclide myocardial perfusion imaging

目的评价核素心肌灌注显像对冠状动脉慢性完全闭塞患者诊断的价值。方法入选2011年8月到2013年9月在西安市中心医院核医学科诊治的冠状动脉慢性完全闭塞病变患者90例,其中男性48例,女性42例,年龄范围20~80岁。同期选择本院检查的非慢性闭塞病变患者90例作为对照组。两组均进行核素心肌灌注显像与冠状动脉造影。结果以冠状动脉造影结果为金标准,观察组中核素心肌灌注显像检出闭塞疾病82例,未检出8例;而对照组中心肌灌注显像正常87例,显示闭塞病变3例（心肌病）。核素心肌灌注显像诊断闭塞疾病的敏感性为91.1%,而特异性为96.7%,阳性预测值96.5%,阴性预测值为91.6%。结论核素心肌灌注显像对冠状动脉慢性完全闭塞诊断价值高,值得推广应用。

Objective To review the diagnostic value of radionuclide myocardial perfusion imaging （RMPI） to chronic coronary total occlusion.Methods The patients （n=90, male 48, female 42 and aged from 20 to 80） were chosen from Aug. 2011 to Sept. 2013 as observation group and other 90 patients with non-chronic coronary total occlusion were chosen as control group. All patients were given examinations of RMPI and coronary angiography （CAG）.Results Taken CAG outcome as gold standard, there were 82 cases of occlusion found out and 8 not found out in observation group, and there were 87 cases with normal RMPI and 3 cases of occlusion found out （myocardial disease） in control group. The sensitivity of RMPI was 91.1%, specificity was 96.7%, positive predictive value was 96.5% and negative predictive value was 91.6% in diagnosis of chronic coronary total occlusion.Conclusion RMPI has higher diagnostic value to chronic coronary total occlusion, which is worth implementation and popularization.