SPECT/CT MPI联合CACS诊断冠心病的临床价值分析

目的分析单光子发射/计算机化断层显象(SPECT/CT)下心肌灌注成像(MPI)联合冠状动脉钙化积分(CACS)应用于冠心病(CAD)诊断的临床效果。方法回顾性分析128例疑似CAD受试者临床资料,根据冠状动脉血管造影术(CAG)检查结果分为CAD组(n=78)与非CAD组(n=50)。比较两组MPI诊断结果及CACS差异,以受试者工作特征(ROC)曲线表征其诊断效能,分析单纯MPI及联合以CACS诊断CAD准确性差异。结果 CAD组MPI阳性率及CACS水平均明显高于非CAD组(P<0.05)。MPI与CACS诊断CAD所得ROC曲线AUC分别为0.674、0.757,敏感度分别为0.679、0.628,特异性分别为0.800、0.720,CACS诊断CAD的Youden指数所对应临界值为95.50分。单纯MPI诊断CAD符合率明显低于MPI联合CACS(P<0.05);MPI联合CACS诊断CAD与CAG一致性良好(K>0.70)。结论 SPECT/CTMPI联合CACS能有效改善CAD诊断准确性,临床应用价值较高。

Clinical Value of SPECT/CT MPI Combined with CACS in the Diagnosis of Coronary Artery Disease

Objective To analyze the clinical effects of myocardial perfusion imaging(MPI) under single photon emission/computerized tomography(SPECT/CT) combined with coronary artery calcification score(CACS) in the diagnosis of coronary artery disease(CAD). Methods The clinical data of 128 subjects suspected as CAD were retrospectively analyzed. According to the results of coronary angiography(CAG), the patients were divided into CAD group(n=78) and non-CAD group(n=50). The MPI diagnosis results and CACS differences were compared between the two groups. The diagnostic efficacy was characterized by receiver operating characteristic(ROC) curve. The differences in CAD accuracy between single MPI and MPI combined with CACS were analyzed. Results The positive rate of MPI and CACS level in CAD group were significantly higher than those in non-CAD group(P<0.05). The AUC values of ROC curve by MPI and CACS in the diagnosis CAD were 0.674 and 0.757 respectively, and the sensitivities were 0.679 and 0.628 respectively, and the specificities were 0.800 and 0.720 respectively. The critical value of Youden index of CACS in the diagnosis CAD was 95.50. The coincidence rate of simple MPI in the diagnosis CAD was significantly lower than that of MPI combined with CACS(P<0.05). The coincidence of MPI combined with CACS and CAG in the diagnosis of CAD were good(K>0.70). Conclusion SPECT/CT MPI combined with CACS can effectively improve the accuracy of CAD diagnosis and has a high clinical application value.