Patil Harshal R, Bateman Timothy M, McGhie A Iain, Burgett Eric V, Courter Staci A, Case James A, Heller Gary V
Saint-Luke's Mid America Heart Institute, 4330 Wornall Road, Suite 2000, Kansas City, MO, 64111, USA.
J Nucl Cardiol. 2014 Feb;21(1):127-34. doi: 10.1007/s12350-013-9817-9. Epub 2013 Nov 21.
There is limited data on diagnostic accuracy of recently introduced high-resolution Anger (HRA) SPECT incorporating attenuation correction (AC), noise reduction, and resolution recovery algorithms. We therefore studied 54 consecutive patients (excluding those with prior MI or cardiomyopathy) who had HRA-AC SPECT and coronary angiography (CA) ≤ 30 days and no change in symptoms.
The HRA-AC studies were acquired in 128 × 128 matrix (3.2 mm pixel) format with simultaneous Gd-153 line-source AC. Measured variables were image quality, interpretive certainty, sensitivity and specificity for any CAD, sensitivity for single- and multivessel CAD, and the influence of gender, body mass index (BMI), and stress modality.
The mean age of the patients was 66 ± 11 years with a BMI of 32 ± 7 kg·m(-2). Mean interpretive certainty score was 2.7 on a 3-point scale and mean image quality score was 3.3 on a 4-point scale. Stress perfusion defects were detected in 34 of 38 patients with obstructive CAD [sensitivity 89%, 95% confidence interval (CI) 76%-95%]. The specificity was 75% (CI 51%-90%) and overall diagnostic accuracy was 85% (CI 73%-92%). Accuracy did not differ for females vs males, for BMI ≤30 vs >30, or for pharmacologic vs exercise SPECT. Sensitivity for single-vessel disease was 88% (CI 69%-96%) and for multivessel disease was 93% (CI 69%-99%).
New Anger technology incorporating innovative improvements results in high image quality with excellent interpretive certainty and high diagnostic accuracy.
关于最近推出的采用衰减校正（AC）、降噪和分辨率恢复算法的高分辨率安捷伦（HRA）单光子发射计算机断层扫描（SPECT）的诊断准确性的数据有限。因此，我们研究了54例连续患者（不包括既往有心肌梗死或心肌病的患者），这些患者在30天内接受了HRA-AC SPECT和冠状动脉造影（CA）检查，且症状无变化。
以128×128矩阵（3.2毫米像素）格式同时进行钆-153线源AC采集HRA-AC研究。测量变量包括图像质量、解释确定性、对任何冠状动脉疾病（CAD）的敏感性和特异性、对单支和多支血管CAD的敏感性，以及性别、体重指数（BMI）和应激方式的影响。
患者的平均年龄为66±11岁，BMI为32±7 kg·m⁻²。在3分制中，平均解释确定性评分为2.7，在4分制中，平均图像质量评分为3.3。在38例阻塞性CAD患者中，有34例检测到应激灌注缺损[敏感性89%，95%置信区间（CI）76%-95%]。特异性为75%（CI 51%-90%），总体诊断准确性为85%（CI 73%-92%）。女性与男性、BMI≤30与>30、药物负荷与运动SPECT之间的准确性无差异。单支血管疾病的敏感性为88%（CI 69%-96%），多支血管疾病的敏感性为93%（CI 69%-99%）。
采用创新性改进的新型安捷伦技术可产生高质量图像，具有出色的解释确定性和高诊断准确性。
