Shin John H, Pokharna Hemlata K, Williams Kim A, Mehta Rupa, Ward R Parker
Section of Cardiology, Department of Medicine, University of Chicago, University of Chicago Hospitals, Chicago, IL 60637, USA.
J Nucl Cardiol. 2009 Jul-Aug;16(4):590-6. doi: 10.1007/s12350-009-9092-y. Epub 2009 May 23.
Recent evidence suggests that combining supine and prone acquisitions during stress-gated SPECT myocardial perfusion imaging (MPS) improves detection of obstructive coronary artery disease (CAD), though the additional imaging time required may not be feasible in routine clinical practice. MPS with prone-only acquisitions is occasionally performed in many laboratories, though little is known about the ability of modern MPS with prone-only acquisitions to detect obstructive CAD. Our goal was to assess the ability of MPS with prone-only acquisitions to detect obstructive CAD as determined by coronary angiography.
We studied 386 patients referred for MPS with either recent coronary angiography or a low pretest likelihood of coronary artery disease. All rest and stress images were obtained exclusively in the prone position. The sensitivity of prone-only MPS was 88% for detecting > or =50% coronary artery stenosis and 92% for detecting > or =70% coronary artery stenosis as determined by coronary angiography. Normalcy rate for prone-only MPS in patients with low probability for CAD was 95%, and normalcy rates did not significantly differ among coronary artery distributions.
The findings of this study suggest that MPS using prone-only acquisitions is a reasonable diagnostic option for the detection of ischemia due to obstructive coronary artery disease.
最近有证据表明,在负荷门控单光子发射计算机断层扫描心肌灌注成像(MPS)期间结合仰卧位和俯卧位采集可提高对阻塞性冠状动脉疾病(CAD)的检测,但在常规临床实践中所需的额外成像时间可能不可行。许多实验室偶尔会进行仅俯卧位采集的MPS,不过对于现代仅俯卧位采集的MPS检测阻塞性CAD的能力了解甚少。我们的目标是评估仅俯卧位采集的MPS检测由冠状动脉造影确定的阻塞性CAD的能力。
我们研究了386例因近期冠状动脉造影或冠状动脉疾病预检可能性低而接受MPS检查的患者。所有静息和负荷图像均仅在俯卧位获得。仅俯卧位MPS检测冠状动脉狭窄≥50%的敏感性为88%,检测冠状动脉狭窄≥70%的敏感性为92%,由冠状动脉造影确定。CAD可能性低的患者中仅俯卧位MPS的正常率为95%,冠状动脉分布之间的正常率无显著差异。
本研究结果表明,仅采用俯卧位采集的MPS是检测阻塞性冠状动脉疾病所致缺血的合理诊断选择。