腺苷负荷99mTc-MIBI门控心肌显像诊断冠心病临床价值

摘要] 目的 以冠状动脉造影（Coronary angiography, CAG）为“金标准”，探讨在腺苷负荷下99mTc-MIBI SPECT门控心肌血流灌注显像（Myocardial perfusion imaging, MPI）对冠心病(Coronary artery disease, CAD)的诊断效能。方法 43例怀疑CAD患者而进行CAG检查的患者,检查前均接受了腺苷99mTc-MIBI负荷门控MPI,观察患者心脏室壁血流灌注情况。与CAG检查结果相对照，比较腺苷负荷介入下MPI对CAD诊断的效能。结果 腺苷负荷MPI诊断CAD的灵敏度为84.6%，特异度为88.2%，准确性为86.0%，对左前降支、回旋支、右冠状动脉狭窄（≥50%）的检测灵敏度和特异度分别为 95.0%和82.6%，77.8%和88.2%，84.6%和70.0%。对单支、双支、3支冠脉病变诊断的灵敏度分别为71.4%，87.5%，100%。结论 腺苷负荷99mTc-MIBI MPI对CAD的诊断准确率高，对诊断无法进行运动患者的冠脉血管病变具有重要临床价值。

Clinical value of adenosine 99mTc-MIBI electrocardiographically gated SPECT myocardial perfusion imaging in coronary artery disease patients

Abstract] Objective This study sought to assess the diagnostic efficacy of adenosine 99mTc-MIBI gated SPECT myocardial perfusion imaging (MPI) in coronary artery disease patients compared with coronary angiography. Method 43 patients who suspected coronary disease had undergone adenosine 99mTc-MIBI gated MPI and coronary angiography, the sensitivity and specificity of adenosine 99mTc-MIBI gated MPI were evaluated. Results The sensitivity, specificity and accuracy of adenosine 99mTc-MIBI gated MPI in detection of coronary artery disease (≥50% diameter stenosis) were: 84.6%, 88.2% and 86.0%, respectively. The sensitivity and specificity for detecting individual diseased vessels were, respectively, 95.0% and 82.6% for the left anterior descending coronary artery, 77.8% and 88.2% for the left circumflex coronary artery and 84.6% and 70.0% for the right coronary artery. Respectively, the corresponding sensitivities of detecting ≥50% diameter stenosis were 78.6%, 87.5% and 100% for single-vessel disease, double-vessel disease and triple-vessel disease. Conclusions Adenosine 99mTc-MIBI gated MPI is an efficient protocol with high sensitivity and specificity for the detection of coronary artery disease in patients unable to perform the exercise test.