Cardiology Service, Brooke Army Medical Center, San Antonio, TX 78234-6200, USA.
J Thorac Imaging. 2012 Jan;27(1):40-3. doi: 10.1097/RTI.0b013e3181fbf983.
To compare the performance of myocardial perfusion imaging (MPI) versus cardiac computed tomographic angiography (CCTA) in patients with a low pretest likelihood of obstructive coronary artery disease and high-risk occupation.
We performed a retrospective chart review of all MPI and CCTA studies performed at our institution from January 2006 to May 2008. The primary outcome measure was the incidence of referral to invasive coronary angiography (ICA).
There were 512 MPS and 170 CCTA studies performed during the study period that met the study criteria. The average age was 35±10 for the CCTA arm and 45±5 for the myocardial perfusion scans (MPS) arm, which was statistically significant (P<0.001), with similar sex distribution between the 2 arms (21% female patients in the MPI arm and 20% female patients in the CCTA arm). The incidence of referral to ICA was 15.8% (81/512) after MPS versus 2.4% (4/170) with CCTA (P<0.001). Among patients referred for ICA, the false-positive rate was 93% (75/81) and 50% (2/4) with MPI and CCTA, respectively (P=0.043).
Compared with MPI, CCTA significantly reduced ICA referral and false-positive noninvasive imaging rates among symptomatic patients with a low probability of coronary artery disease but high occupational risk.
比较心肌灌注成像（MPI）与心脏计算机断层血管造影（CCTA）在低冠心病患病可能性和高职业风险的患者中的表现。
我们对 2006 年 1 月至 2008 年 5 月期间在我们机构进行的所有 MPI 和 CCTA 研究进行了回顾性图表审查。主要观察指标是转诊进行有创冠状动脉造影（ICA）的发生率。
研究期间共有 512 项 MPI 和 170 项 CCTA 研究符合研究标准。CCTA 组的平均年龄为 35±10 岁，MPI 组的平均年龄为 45±5 岁，差异有统计学意义（P<0.001），两组之间的性别分布相似（MPI 组中 21%的女性患者和 CCTA 组中 20%的女性患者）。MPI 后 ICA 转诊率为 15.8%（81/512），CCTA 为 2.4%（4/170）（P<0.001）。在转诊进行 ICA 的患者中，MPI 的假阳性率为 93%（75/81），CCTA 为 50%（2/4）（P=0.043）。
与 MPI 相比，CCTA 显著降低了低冠心病患病可能性但高职业风险的症状性患者的 ICA 转诊率和假阳性无创成像率。
