Department of Medicine (Cardiology), University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
J Nucl Cardiol. 2010 Jan-Feb;17(1):52-60. doi: 10.1007/s12350-009-9153-2. Epub 2009 Oct 14.
Relative myocardial perfusion imaging may underestimate severity of coronary disease (CAD), particularly in cases of balanced ischemia. Can quantification of peak left (LV) and right (RV) ventricular Rb-82 uptake measurements identify patients with left main or 3 vessel disease?
Patients (N = 169) who underwent Rb-82 PET MPI and coronary angiography were categorized as having no significant coronary stenosis (n = 60), 1 or 2 vessel disease (n = 81), or left main disease/3 vessel disease (n = 28), based on angiography. Maximal LV and RV ventricular myocardial Rb-82 uptake was measured during stress and rest.
Failure to augment LV uptake by >or= 8500 Bq/cc at stress, predicted left main or 3 vessel disease with a sensitivity of 93% and specificity of 61% (area under curve = 0.83). A >or=10% increase in RV: LV uptake ratios with stress over rest was 93% specific (area under curve = 0.74) for left main or 3 vessel disease. These indices incrementally predicted left main or 3 vessel disease compared to models including age, gender, cardiac risk factors, and summed stress and difference scores.
Quantifying maximal rest and stress LV and RV uptake with PET myocardial perfusion imaging may independently and incrementally identify patients with left main or 3 vessel disease.
相对心肌灌注成像可能低估冠状动脉疾病（CAD）的严重程度，尤其是在平衡缺血的情况下。左心室（LV）和右心室（RV）摄取峰值的定量测量是否可以识别出左主干或 3 支血管病变患者？
根据血管造影结果，将接受 Rb-82 PET MPI 和冠状动脉造影的患者分为无明显冠状动脉狭窄（n = 60）、1 或 2 支血管病变（n = 81）或左主干病变/3 支血管病变（n = 28）。在应激和休息时测量最大 LV 和 RV 心室心肌 Rb-82 摄取。
LV 摄取在应激时未能增加>或= 8500 Bq/cc，预测左主干或 3 支血管病变的敏感性为 93%，特异性为 61%（曲线下面积 = 0.83）。与包括年龄、性别、心脏危险因素以及总和应激和差异评分的模型相比，RV：LV 摄取比值在应激时较休息时增加>或=10%，对左主干或 3 支血管病变具有 93%的特异性（曲线下面积 = 0.74）。与包括年龄、性别、心脏危险因素以及总和应激和差异评分的模型相比，这些指数独立且递增地预测了左主干或 3 支血管病变。
用正电子发射断层扫描心肌灌注成像定量测量最大静息和应激 LV 和 RV 摄取，可能独立且递增地识别出左主干或 3 支血管病变患者。
