Doğan Cem, Çınaral Ferahnaz, Karagöz Ali, Bayram Zübeyde, Önal Selami Çağatay, Candan Özkan, Acar Rezzan Deniz, Çap Murat, Erdoğan Emrah, Hakgör Aykun, Akbal Özgür Yaşar, Uslu Abdulkadir, Kaymaz Cihangir, Özdemir Nihal
Department of Cardiology, Kartal Koşuyolu High Speciality Training and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2019 Jul;47(5):357-364. doi: 10.5543/tkda.2019.03367.
The aim of this study was to assess the validity of automated quantitative and semiquantitative visual analysis of total perfusion deficit (TPD) using the IQ SPECT gamma camera system compared to conventional coronary angiographically detected significant coronary artery disease (CAD).
The study included patients with suspected CAD who underwent myocardial perfusion single photon emission computed tomography and conventional coronary angiography. The summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) (semiquantitative visual analysis results) were assessed using a 5-point scale in a standard 17-segment model, and TPD (stress, rest, and ischemic TPD) was quantified using automated software.
In all, 84 patients (Group 1, those who underwent revascularization) had significant coronary artery lesions, and 81 (Group 2) had non-significant lesions. The median interquartile range values were: stress-TPD (sTPD): 16 (3.5- 33.5) vs 9.2 (2-17.9), rest-TPD: 9.4 (2.2-18.8) vs 4 (1-11), and 6.9 (1.9-14.1) vs 3.4 (1-6.1) for ischemic-TPD (iTPD) in Group 1 and Group 2, respectively. To detect ischemia, the optimal cut-off points were 9.5 (sensitivity: 75%, specificity; 60%) for sTPD, and 4.5 (sensitivity: 56%, specificity: 73%) for iTPD. There were significant correlations between quantitative and semi-quantitative methods in detection of significant coronary artery disease (sTPD-SSS: r=0.954, sTPD-SDS: r=0.746, iTPD-SSS: r=0.654, iTPD-SDS: r=0.759; p<0.05 for all).
The quantitative analysis and summed stress scores produced by the IQ SPECT system appear to be a useful and valid method to detect significant CAD.
本研究旨在评估使用IQ SPECT伽马相机系统对总灌注缺损（TPD）进行自动定量和半定量视觉分析的有效性，并与传统冠状动脉造影检测到的显著冠状动脉疾病（CAD）进行比较。
该研究纳入了疑似CAD且接受心肌灌注单光子发射计算机断层扫描和传统冠状动脉造影的患者。使用标准的17节段模型，采用5分制评估总应力评分（SSS）、总静息评分（SRS）和总差异评分（SDS）（半定量视觉分析结果），并使用自动化软件对TPD（应力、静息和缺血性TPD）进行量化。
总共84例患者（第1组，接受血运重建的患者）有显著冠状动脉病变，81例（第2组）有非显著病变。第1组和第2组的中位数四分位间距值分别为：应力性TPD（sTPD）：16（3.5 - 33.5）对9.2（2 - 17.9），静息性TPD：9.4（2.2 - 18.8）对4（1 - 11），缺血性TPD（iTPD）：6.9（1.9 - 14.1）对3.4（1 - 6.1）。为检测缺血，sTPD的最佳截断点为9.5（敏感性：75%，特异性：60%），iTPD的最佳截断点为4.5（敏感性：56%，特异性：73%）。在检测显著冠状动脉疾病方面，定量和半定量方法之间存在显著相关性（sTPD - SSS：r = 0.954，sTPD - SDS：r = 0.746，iTPD - SSS：r = 0.654，iTPD - SDS：r = 0.759；所有p < 0.05）。
IQ SPECT系统产生的定量分析和总应力评分似乎是检测显著CAD的一种有用且有效的方法。
