O-Water 正电子发射断层扫描术评估经皮冠状动脉介入治疗患者的心肌缺血。
O-Water Positron Emission Tomography of Myocardial Ischemia in Patients Referred for Percutaneous Coronary Intervention.
机构信息
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
出版信息
Cardiovasc Revasc Med. 2020 Oct;21(10):1237-1243. doi: 10.1016/j.carrev.2020.03.010. Epub 2020 Mar 7.
The diagnostic accuracy of non-invasive diagnostic methods for detecting coronary artery disease has increased in recent years. This study aimed to assess the diagnostic performance of O-water positron emission tomography (PET) in terms of stress myocardial blood flow (MBF) and myocardial flow reserve (MFR) in patients with single-vessel disease referred for percutaneous coronary intervention (PCI), using fractional flow reserve (FFR) value of ≤0.80 as the reference for a significant stenosis. We also assessed the influence of the index of microcirculatory resistance (IMR) on the diagnostic performance of PET. O-water PET FFR and IMR were measured before PCI in 26 patients with single-vessel disease. Stress MBF < 2.5 ml/min/g (95% confidence interval [CI]) had sensitivity 78% (95% CI: 52%-94%), specificity 50% (95% CI: 16%-84%), positive predictive value (PPV) 78% (95% CI: 63%-88%), negative predictive value (NPV) 50% (95% CI: 25%-75%), and accuracy 69% (95% CI: 48%-86%). MFR < 2.5 had sensitivity 72% (95% CI: 47%-90%), specificity 75% (95% CI: 35%-97%), PPV 87% (95% CI: 65%-96%), NPV 55% (95% CI: 34%-74%), and accuracy 73% (95% CI: 52%-88%). In patients with IMR > 24, stress MBF correlated with FFR (r = 0.651; p = 0.016) whereas stress MBF did not correlate with FFR in patients with IMR < 24. In conclusion, stress MBF and MFR had modest diagnostic performance compared to invasive FFR measurements in patients with single-vessel disease.
近年来，非侵入性诊断方法检测冠状动脉疾病的诊断准确性有所提高。本研究旨在评估 O-水正电子发射断层扫描（PET）在单支血管病变患者经皮冠状动脉介入治疗（PCI）中，以压力心肌血流（MBF）和心肌血流储备（MFR）为指标，以血流储备分数（FFR）值≤0.80 作为有意义狭窄的参考，评估其诊断性能。我们还评估了微血管阻力指数（IMR）对 PET 诊断性能的影响。在 26 例单支血管病变患者中，在 PCI 前测量了 O-水 PET FFR 和 IMR。应激 MBF<2.5ml/min/g（95%置信区间[CI]：52%-94%）的敏感性为 78%（95%CI：52%-94%），特异性为 50%（95%CI：16%-84%），阳性预测值（PPV）为 78%（95%CI：63%-88%），阴性预测值（NPV）为 50%（95%CI：25%-75%），准确性为 69%（95%CI：48%-86%）。MFR<2.5 的敏感性为 72%（95%CI：47%-90%），特异性为 75%（95%CI：35%-97%），PPV 为 87%（95%CI：65%-96%），NPV 为 55%（95%CI：34%-74%），准确性为 73%（95%CI：52%-88%）。在 IMR>24 的患者中，应激 MBF 与 FFR 相关（r=0.651；p=0.016），而在 IMR<24 的患者中，应激 MBF 与 FFR 不相关。结论：在单支血管病变患者中，与有创 FFR 测量相比，应激 MBF 和 MFR 的诊断性能中等。
Zotero 插件