Li Jian-Ming, Li Ting, Shi Rong-Fang, Zhang Li-Ren
Department of Nuclear Medicine, Tianjin Medical University, Cardiovascular Clinical Institute and TEDA International Cardiovascular Hospital, Tianjin 300457, China.
Int J Mol Imaging. 2012;2012:253475. doi: 10.1155/2012/253475. Epub 2012 Jul 16.
The study aims to discuss the relationship and difference between myocardial perfusion imaging (MPI) using SPECT and CT coronary angiography (CTCA) for diagnosis of coronary artery disease (CAD). Five hundred and four cases undergoing MPI and CTCA were comparatively analyzed, including fifty six patients undergoing invasive coronary angiography in the same period. Among patients with negative MPI results, negative or positive CTCA occupied 84.7% or 15.3%, respectively. Among patients with positive MPI, positive or negative CTCA occupied 67.2% or 32.8%, respectively. Among patients with negative CTCA, negative or positive MPI occupied 94.4% or 5.6%, respectively. Among patients with positive CTCA, positive or negative MPI occupied 40.2% or 59.8%, respectively. Negative predictive value was relatively higher than the positive predictive value for positive CTCA eliminating or predicting abnormal haemodynamics. And there was no significant difference for sensitivity, specificity, and accuracy of MPI or CTCA in diagnosing CAD. Both MPI and CTCA have good diagnostic performance for CAD. They provide different and complementary information for diagnosis and evaluation of CAD, namely, detection of ischemia versus detection of atherosclerosis, which are quite different but have a definite internal link for each other.
本研究旨在探讨单光子发射计算机断层扫描心肌灌注成像(MPI)与CT冠状动脉造影(CTCA)在诊断冠状动脉疾病(CAD)方面的关系及差异。对504例行MPI和CTCA检查的病例进行了对比分析,其中包括同期行有创冠状动脉造影的56例患者。MPI结果为阴性的患者中,CTCA阴性或阳性分别占84.7%或15.3%。MPI结果为阳性的患者中,CTCA阳性或阴性分别占67.2%或32.8%。CTCA结果为阴性的患者中,MPI阴性或阳性分别占94.4%或5.6%。CTCA结果为阳性的患者中,MPI阳性或阴性分别占40.2%或59.8%。对于CTCA阳性排除或预测异常血流动力学而言,阴性预测值相对高于阳性预测值。MPI或CTCA在诊断CAD时的敏感性、特异性和准确性无显著差异。MPI和CTCA对CAD均具有良好的诊断性能。它们为CAD的诊断和评估提供了不同且互补的信息,即缺血检测与动脉粥样硬化检测,二者虽截然不同但彼此具有明确的内在联系。