Laarman G J, Bruschke A V, Verzijlbergen J F, Go T L, Bal E T, Van Der Wall E E, Ascoop C A
Thoraxcenter, Erasmus University Rotterdam, The Netherlands.
Eur Heart J. 1990 Feb;11(2):162-72. doi: 10.1093/oxfordjournals.eurheartj.a059673.
To determine the value and limitations of quantitative analysis of thallium-201 imaging after intravenous dipyridamole in combination with low level exercise, 81 patients with suspected coronary artery disease (CAD) were evaluated prospectively. The results of quantitative analysis were compared with the results of visual analysis. All patients underwent coronary arteriography and left ventricular angiography. Significant CAD was present in 59 patients (73%); multivessel CAD was observed in 33 patients (42%). Mild side-effects such as headache, vertigo and nausea were experienced by 12 patients (15%). To establish 'test-specific' normal limits in quantitative analysis of uptake and washout of thallium-201 after dipyridamole infusion with low level exercise we studied 20 healthy volunteers with a likelihood of CAD less than or equal to 1%. Sensitivity and specificity of quantitative analysis for overall detection of significant CAD were 76% and 73%, respectively vs 78% and 86%, respectively with visual analysis (P = NS). Sensitivity for the detection of multivessel CAD was slightly higher with quantitative analysis (73%) than with visual analysis (70%), but the specificity was lower (75% vs 92%) (P = NS). Sensitivity of quantitative analysis in relation to vessels involved was slightly lower than with visual analysis (RCA and LAD: P = NS; LCX: P less than 0.05). Of 14 patients with false-negative results, four had multivessel CAD. Thus, quantitative analysis after the combination of dipyridamole infusion with low level exercise did not improve the diagnostic value as assessed by semi-quantitative visual analysis.
为了确定静脉注射双嘧达莫联合低水平运动后进行铊-201心肌显像定量分析的价值及局限性，我们对81例疑似冠心病（CAD）患者进行了前瞻性评估。将定量分析结果与视觉分析结果进行比较。所有患者均接受了冠状动脉造影和左心室造影。59例患者（73%）存在显著CAD；33例患者（42%）观察到多支血管CAD。12例患者（15%）出现了如头痛、眩晕和恶心等轻度副作用。为了建立双嘧达莫输注联合低水平运动后铊-201摄取和洗脱定量分析的“试验特异性”正常范围，我们研究了20名CAD可能性小于或等于1%的健康志愿者。定量分析对显著CAD总体检测的敏感性和特异性分别为76%和73%，而视觉分析分别为78%和86%（P = 无显著性差异）。定量分析检测多支血管CAD的敏感性略高于视觉分析（73%对70%），但特异性较低（75%对92%）（P = 无显著性差异）。定量分析相对于受累血管的敏感性略低于视觉分析（右冠状动脉和左前降支：P = 无显著性差异；左旋支：P < 0.05）。在14例假阴性结果的患者中，4例有多支血管CAD。因此，双嘧达莫输注联合低水平运动后的定量分析并未提高经半定量视觉分析评估的诊断价值。
