^(99m)Tc-MIBI心肌SPECT显像诊断冠心病及检测存活心肌

^(99m)Tc-MIBI myocardial perfusion SPECT in diagnosing coronary artery disease and assessing myocardial viability

目的:评估99mTc-甲氧基异丁基异腈（MIBI）心肌断层显像诊断冠心病及检测存活心肌的临床应用价值。方法:24例患者行潘生丁药物负荷及静息心肌断层显像;20例心肌梗死患者在血管重建术前行静息及硝酸甘油介入心肌断层显像,血管重建术后1个月重复行静息心肌断层显像。44例患者均行冠状动脉造影。分析对比心肌断层显像与冠状动脉造影结果以及血管重建术前后的心肌断层显像结果。结果:99mTc-MIBI心肌断层显像对冠心病诊断敏感性为94％,阳性预测值为86％;硝酸甘油介入99mTc-MIBI心肌断层显像对存活心肌的阳性预测值为86％,阴性预测值为79％,预测准确率为83％。结论;99mTc-MIBI心肌断层显像在诊断冠心病,检测存活心肌方面有较大的临床应用价值。

Objective:To evaluate the clinical value of 99mTc-MIBI myocardial perfusion SPECT in diagnosing coronary artery disease (CAD) and assessing myocardial viability. Methods:Rest and dipyridamole stress 99mTc-MIBI SPECT were performed in 24 patients. Rest and nitroglycerin (NTG) 99m Tc-MIBI SPECT were performed in 20 cases with myocardial infarction before revascularization and rest imaging was repeated one month after revasculariztion. All 44 patients underwent coronary angiography. We compared and analyzed the results of 99mTc-MIBI SPECT and coronary angiography and 99m Tc-MIBI SPECT before and after revasculariztion. Results: The sensitivity of 99m Tc-MIBI SPECT for CAD was 94% , the positive predictive value (PPV) was 86% . The PPV of NTG 99m Tc-MIBI SPECT for myocardial viability was 86% , negative predictive value (NPV) was 79% , and accuracy was 83% . Conclusion: 99mTc-MIBI SPECT possesses a powerful clinical value in diagnosing CAD and assessing myocardial viability.