门控心肌灌注显像局部室壁运动异常判断冠状动脉狭窄程度的价值

姚立新; 刘彬彬

姚立新 , 刘彬彬

文章导航 > 国际放射医学核医学杂志 > 2007, 31 > 2: (90-93)

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门控心肌灌注显像局部室壁运动异常判断冠状动脉狭窄程度的价值

姚立新¹,
刘彬彬²

1. 066000 秦皇岛, 秦皇岛市第一医院核医学科;
2. 066000 秦皇岛, 秦皇岛市第一医院功能科
中图分类号: R817.4

The value of regional wall motion abnormalities on gated mycardiac perfusion imaging in predicting angiographic stenoses of coronary artery

YAO Li-xin¹,
LIU Bin-bin²

1. Department of NuclearMedicine, The First Hospital of Qinhuangdao, Qin-huangdao 066000, China;
2. Department of Fuction, The First Hospital of Qinhuangdao, Qin-huangdao 066000, China
CLC number: R817.4

摘要: 目的探讨_99mTc-甲氧基异丁基异腈(_99mTc-MIBI)门控心肌灌注显像出现的可逆性局部室壁运动异常(RWMA)在判断冠状动脉狭窄程度中的价值。方法入选90例疑似冠心病患者,在门控心肌灌注显像的前后2周内进行冠状动脉造影检查。门控心肌SPECT检查应用9节段5分制进行室壁运动及增厚率评分。结果心肌显像上可逆性RWMA判断≥75%的冠状动脉狭窄的灵敏度为64%,特异度为95%;用可逆性RWMA来区别严重冠状动脉狭窄(≥75%)和不严重的冠状动脉狭窄(<75%)有很高的阳性预测值(97%)。可逆性RWMA和濒危冠状动脉评分之间有良好的相关性。多因素分析显示,负荷室壁负荷总积分、室壁负荷差分值和心电图负荷试验阳性是濒危冠状动脉积分的独立危险因子。结论根据_99mTc-MIBI门控心肌灌注显像上可逆性RWMA判断严重冠状动脉狭窄具有高度的特异性和阳性预测值。潘生丁负荷后及可逆性RWMA增强了心肌灌注显像对冠状动脉狭窄程度的评估。
- 冠状动脉狭窄 /
- 潘生丁 /
- 99m锝甲氧基异丁基异腈 /
- 体层摄影术 /
- 发射型计算机 /
- 单光子
Abstract: Objective To determine the possible level of angiographic stenoses of coronary artery at which reversible regional wall motion abnormalities (RWMA) are present on _99mTc-sestamibi (_99mTc-MIBI)-gated myocardial perfusion imaging (MPI). Methods ninty patients undergoing coronary angiography MPI within two weeks were recruited. A five grades and nine segments marking system was introduced to assess the RWMA and thickening of left ventricles. Results The sensitivity of reversible RWMA for detecting ≥75% angiographic stenoses was 64%,with a specificity of 95% and positive predictive value of 97%.The presence of reversible RWMA was able to stratify patients with severe angiographic stenoses of 75% or more from those less than 75% with high positive predictive value. A good correlation was noted between the presence of reversible RWMA and the coronary artery jeopardy score. Multivariate analysis showed that the post-stress RWMA and reversible RWMA scores and positive dipyridamole-stress exercise electrocardiogram(ECG) were significant predictors of angiographic severity. Conclusions Reversible RWMA, as shown by dipyridamole stress _99mTc-MIBI MPI, is a significant predictor of angiographic disease with very high specificity and adds incremental value to MPI for the assessment of angiographic severity.
- Coronary stenosis /
- Dipyridamole /
- Technetium 99m sestamibi /
- Tomograghy /
- emission computed /
- single photon
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门控心肌灌注显像局部室壁运动异常判断冠状动脉狭窄程度的价值

姚立新¹
刘彬彬²

1. 066000 秦皇岛, 秦皇岛市第一医院核医学科;
2. 066000 秦皇岛, 秦皇岛市第一医院功能科

收稿日期: 2006-11-07

关键词:

摘要: 目的探讨_99mTc-甲氧基异丁基异腈(_99mTc-MIBI)门控心肌灌注显像出现的可逆性局部室壁运动异常(RWMA)在判断冠状动脉狭窄程度中的价值。方法入选90例疑似冠心病患者,在门控心肌灌注显像的前后2周内进行冠状动脉造影检查。门控心肌SPECT检查应用9节段5分制进行室壁运动及增厚率评分。结果心肌显像上可逆性RWMA判断≥75%的冠状动脉狭窄的灵敏度为64%,特异度为95%;用可逆性RWMA来区别严重冠状动脉狭窄(≥75%)和不严重的冠状动脉狭窄(<75%)有很高的阳性预测值(97%)。可逆性RWMA和濒危冠状动脉评分之间有良好的相关性。多因素分析显示,负荷室壁负荷总积分、室壁负荷差分值和心电图负荷试验阳性是濒危冠状动脉积分的独立危险因子。结论根据_99mTc-MIBI门控心肌灌注显像上可逆性RWMA判断严重冠状动脉狭窄具有高度的特异性和阳性预测值。潘生丁负荷后及可逆性RWMA增强了心肌灌注显像对冠状动脉狭窄程度的评估。