13N-NH3PET腺苷负荷—静息心肌灌注显像在冠状动脉病变功能学评价中的应用价值

目的探讨13N-NH3PET腺苷负荷—静息心肌灌注显像（MPI）在疑诊或确诊冠心病患者冠脉病变功能学评价中的应用价值。方法 30例疑似或确诊的冠心病患者,均接受13N-NH3PET腺苷负荷—静息MPI和冠状动脉造影（CAG）检查。结果用13N-NH3PET腺苷负荷—静息MPI评估30例患者197个冠状动脉节段供血区,结果50个节段供血区确定为存活心肌（24个节段供血区发现可逆性灌注缺损,26个节段供血区呈固定性灌注缺损）,3个节段供血区确定为无存活心肌,其余144个节段供血区为正常心肌。以CAG发现≥50%狭窄为CAG检查结果阳性标准,30例中MPI与CAG结果相符合者24例。阳性22例、假阳性5例、假阴性1例、阴性2例。敏感度95.65%、特异度28.57%、阳性预测值81.48%、阴性预测值66.67%。以CAG发现≥75%狭窄为CAG阳性标准,30例中MPI结果与CAG结果相符合者25例。其中阳性22例、假阳性5例、假阴性0例、阴性3例。敏感度为100%、特异度为37.5%、阳性预测值为81.48%、阴性预测值为100%。结论 MPI用于疑似或确诊冠心病患者冠状动脉功能学评价效果较好。

13 N-NH3 PET adenosine stress myocardial perfusion imaging in diagnosis of coronary heart disease

Objective To explore the value of 13 N-NH3 PET adenosine stress -resting myocardial perfusion imaging （ MPI） in the diagnosis of coronary heart disease, coronary artery lesions function to evaluate the feasibility of learning. Methods 0patientswithcoronaryheartdisease（CHD）weredetectedwith13N-NH3PETadenosinestress-restingandcor-onary angiography.Method 30 cases of patients with two day MPI.All patients were performed coronary angiography in 1 months.Results On the basis of coronary angiography found 50%or more narrow,the sensitivity of MPI was 95.65%,spe-cific degrees was 28.57%,positive predictive value was 81.48%,negative predictive value was 66.67%.On the basis of cor-onary angiography found 75%or more narrow,the sensitivity of MPI was 100%,specific degrees was 37.5%,positive predic-tive value was 81.48%,negative predictive value was 100%. Conclusion MPI can serve as effective index of the diagnosis of CHD, is also a very good function of coronary artery evaluation index.