可疑冠心病患者核素显像与CT冠状动脉造影对比分析

目的探讨核素心肌灌注显像（MPI）和CT冠状动脉造影（CTCA）2种无创性检查方法在可疑冠心病（CAD）患者诊断中的关系。方法对40例可疑冠心病患者行冠状动脉造影（CAG）、MPI和CTCA检查，均在2个月内进行。MPI结果分为正常和异常可逆性和（或）不可逆性心肌缺血]；CTCA结果分为正常、轻度（狭窄〈50％）和中度及其以上狭窄（至少1支主要血管或主要分支血管狭窄程度≥50％）。以CAG结果为“金标准”，对40例患者的MPI和CTCA结果进行对比分析。结果CTCA正常者中，90．1％的患者MPI正常；CTCA异常者中，55．2％的患者MPI正常；而MPI正常者中，61．5％的患者CTCA均有不同程度的狭窄。与CAG比较，CTCA的灵敏度、特异性和准确性高，分别为96．4％（27／28）、83．3％（10／12）和92．5％（37／40）。结论MPI和CTCA在可疑冠心病患者的诊断中提供了不同但却互补的信息，两者应合理联合应用。

Comparative analysis of myocardial perfusion imaging and CT coronary arteriography in diagnosis of patients with suspected coronaryartery disease

Objective The aim of this study was to analyze the relationship between myocardial perfusion imaging (MPI) and computed tomography coronary artefiography (CTCA) in diagnosis of patients with suspected coronary artery disease (CAD).Methods Forty patients with suspected CAD underwent invagive coronary angiography(CAG),MPI and CTCA within 2 months.The results of myocardial perfusion imaging were classified as normal or abnormalreversible and(or)fixed defects] ;The CTCA studies were classified as normal,non-obstructive(＜50% stenosis)CAD,or obstructive CAD.Taking the results of CAG as"gold standard",the findings of MPI and CTCA were comparatively analyzed.Concordant and discordant results between MPI and CTCA were statistically analyzed using Kappa test.P＜0.05 Was considered statistically significant.Results Aboat 90.1% patients with normal CTCA also showed normal MPI.However,only 44.8% patients with abnormal CTCA showed corresponding perfusion abnormalities on MPI.Conversely,61.5% patients with normal MPI had abnormal CTCA.Compared with CAG,the sensitivity,specificity and accuracy of CTCA were 96.4%(27/28),83.3%(10/12) and 92.5%(37/40),and those of MPI were 46.4%(13/28),91.7%(11/12)and 60.0%(24/40) respectively.Conclusions MPI and CTCA provide different but complementary information in diagnosis of patients with suspected CAD.Their clinical value and application should be practically combined.