Verzijlbergen J F, Cramer M J, Niemeyer M G, Ascoop C A, Van der Wall E E, Pauwels E K
Department of Nuclear Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
Am J Physiol Imaging. 1990;5(2):60-7.
To assess the diagnostic accuracy of planar diastolic and static Technetium-99m-SESTAMIBI, myocardial perfusion imaging at rest and during exercise, was performed in 60 consecutive patients. The results were compared with coronary angiographic findings, obtained within 3 months of the exercise test and Thallium-201 images, obtained on the same day and to the same exercise level as Technetium-99m-SESTAMIBI exercise. Exact segmental concordance between static Technetium-99m-SESTAMIBI and Thallium-201 was 77% and between the diastolic images and Thallium-201 76%. Concordance between static and diastolic images was 92%. Nineteen percent of all 900 segments demonstrated ischemia with both static and diastolic Technetium-99m-SESTAMIBI and 20% with Thallium-201. Overall sensitivity to detect hemodynamically significant coronary artery disease with static Technetium-99m-SESTAMIBI was 86%, specificity 78%, with diastolic images 89% and 70% and with Thallium-201 89% and 78% (differences not significant). Vessel-specific comparative detection rates revealed no statistical significant differences between both radiopharmaceuticals as well. Intra-observer variability for the static images was 12%, for the diastolic images 21% and Thallium-201 14%. Inter-observer variability for the static images was 14%, diastolic images 24%, and Thallium-201 17%. Although the physical characteristics of Tc-SESTAMIBI enable to perform high-count density imaging and electrocardiographic gating, no significant differences are found when planar diastolic and static Technetium-99m-SESTAMIBI images are compared with Thallium-201 and are well within observer variabilities.
为评估平面舒张期和静态锝-99m-甲氧基异丁基异腈（Technetium-99m-SESTAMIBI）心肌灌注显像的诊断准确性，对60例连续患者进行了静息和运动时的心肌灌注显像。将结果与运动试验后3个月内获得的冠状动脉造影结果以及与锝-99m-SESTAMIBI运动试验同一天、相同运动水平的铊-201（Thallium-201）图像进行比较。静态锝-99m-SESTAMIBI与铊-201之间的节段精确一致性为77%，舒张期图像与铊-201之间为76%。静态和舒张期图像之间的一致性为92%。在所有900个节段中，19%在静态和舒张期锝-99m-SESTAMIBI显像时均显示缺血，铊-201显像时为20%。静态锝-99m-SESTAMIBI检测血流动力学显著冠状动脉疾病的总体敏感性为86%，特异性为78%，舒张期图像分别为89%和70%，铊-201分别为89%和78%（差异无统计学意义）。血管特异性比较检测率显示两种放射性药物之间也无统计学显著差异。静态图像的观察者内变异性为12%，舒张期图像为21%，铊-201为14%。静态图像的观察者间变异性为14%，舒张期图像为24%，铊-201为17%。尽管锝-SESTAMIBI的物理特性能够进行高计数密度成像和心电图门控，但将平面舒张期和静态锝-99m-SESTAMIBI图像与铊-201图像进行比较时未发现显著差异，且均在观察者变异性范围内。
