201铊心肌灌注闪烁显像在冠状动脉疾病中诊断性能的改善：从平面显像到单光子发射计算机断层显像

Improved diagnostic performance of thallium-201 myocardial perfusion scintigraphy in coronary artery disease: from planar to single photon emission computed tomography imaging.

作者信息

Tsai Ming-Fong, Kao Pan-Fu, Tzen Kai-Yuan

机构信息

Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.

出版信息

Chang Gung Med J. 2002 Aug;25(8):522-30.

PMID:12392364

Abstract

BACKGROUND

This study was performed to compare Tl-201 myocardial perfusion single photon emission computed tomography (SPECT) with planar scintigraphy in the diagnosis of coronary artery disease (CAD).

METHODS

Retrospectively, 240 of 3262 patients, with exercise-redistribution Tl-201 myocardial perfusion scintigraphy performed between January 1990 and October 1997, were analyzed to compare Tl-201 scintigraphy and coronary arteriography. Within 30 days, all 240 patients underwent both coronary arteriography and exercise-redistribution Tl-201 myocardial perfusion scintigraphy with 86 SPECT and 154 planar images acquired.

RESULTS

The sensitivities of Tl-201 myocardial perfusion scintigraphy in individual coronary arteries including left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA), were 77%/72%, 31%/30%, and 77%/50% in the SPECT/planar study groups, respectively. The sensitivities of CAD detection in patients with single-vessel, double-vessel, and triple-vessel diseases were 96%/82%, 91%/85%, and 96%/90% in the SPECT/planar study groups, respectively.

CONCLUSION

SPECT images provide greater advantages over planar images for better detection of the number, location, and extent of CAD. Cardiac SPECT does improve the accurate interpretation in abnormal Tl-201 distributions due to the higher contrast resolution and better separation of overlapping myocardial regions.

摘要

背景

本研究旨在比较铊-201心肌灌注单光子发射计算机断层扫描（SPECT）与平面闪烁扫描在冠状动脉疾病（CAD）诊断中的应用。

方法

回顾性分析1990年1月至1997年10月间进行运动再分布铊-201心肌灌注闪烁扫描的3262例患者中的240例，以比较铊-201闪烁扫描与冠状动脉造影。在30天内，所有240例患者均接受了冠状动脉造影和运动再分布铊-201心肌灌注闪烁扫描，共采集了86例SPECT图像和154例平面图像。

结果

在SPECT/平面研究组中，铊-201心肌灌注闪烁扫描对包括左前降支（LAD）动脉、左旋支（LCX）动脉和右冠状动脉（RCA）在内的各冠状动脉的敏感性分别为77%/72%、31%/30%和77%/50%。SPECT/平面研究组中，单支血管、双支血管和三支血管疾病患者CAD检测的敏感性分别为96%/82%、91%/85%和96%/90%。