99mTc-N-NOET运动心肌灌注显像诊断冠状动脉疾病

目的 探讨^99mTc-N-NOET( NOET) 运动肺/心比值对冠状动脉疾病(CAD)多支病变的诊断价值及其与左室舒张功能的相关性。方法 对49例经冠状动脉造影病人进行NOET运动-延迟心肌灌注断层显像,其中29例经冠状动脉造影证实动脉狭窄≥50%,20例冠状动脉正常。结果 NOET运动心肌灌注断层显像对CAD的诊断敏感性和特异性分别为86.2%和95.0%。多支病变组(0.76±0.13)NOET运动肺/心比值显著高于单支病变(0.62±0.06)和冠脉正常组(0.58±0.13)(F=18.04,P=0.002-0.001)。当NOET运动肺/心比值≥0.70时,其对冠脉多支病变的诊断敏感性和特异性分别为93.5%和83.3%。NOET运动肺/心比值与E/A比值具有非常显著的负相关性(r=-0.771, P<0.000 1)。结论 NOET运动肺/心比值对CAD病人的多支病变和左室舒张功能异常均具有诊断价值。

99mTc-N-NOET myocardial perfusion imaging during exercise for diagnosis of coronary artery disease

Objective To investigate the value of ^99mTc-N-NOET(NOET) myocardial perfusion imaging during exercise in the diagnosis of coronary artery disease (CAD), and the relationship between exercise NOET lung/heart ratio and left ventricular diastolic function. Methods Exercise-delayed NOET myocardial perfusion imaging was performed in 49 patients undergoing coronary angiography, among whom 29 had coronary stenosis≥50% and 20 normal coronary artery. Results The sensitivity and specificity of exercise NOET myocardial perfusion imaging were 86.2% and 95.0%, respectively, in the detection of CAD. The NOET lung/heart ratio of CAD patients with multiple branch involvement (0.76±0.13) was significantly higher than those of patients with single branch lesion (0.62±0.06) and with normal coronary artery (0.58±0.13, F=18.04, P=0.002-0.001). When the lung/heart ratio was over 0.70, the sensitivity and specificity of the imaging for detecting the presence of multiple branch involvement were 93.5% and 83.3%, respectively. NOET lung/heart ratio showed a significant correlation with E/A ratio (r=-0.771, P<0.000 1). Conclusion Exercise NOET lung/heart ratios has diagnostic values for multiple branch lesions and left ventricular diastolic function abnormalities in patients with CAD.