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采用 CZT SPECT 进行低剂量动态心肌灌注成像的新定量参数对疑似或已知冠心病的诊断分析。

Diagnostic analysis of new quantitative parameters of low-dose dynamic myocardial perfusion imaging with CZT SPECT in the detection of suspected or known coronary artery disease.

机构信息

Nuclear Medicine Department, Tianjin Medical University Clinical Cardiovascular Institute, TEDA International Cardiovascular Hospital, Tianjin, 300457, China.

出版信息

Int J Cardiovasc Imaging. 2021 Jan;37(1):367-378. doi: 10.1007/s10554-020-01962-x. Epub 2020 Sep 10.

Abstract

The goal of this study is to explore and evaluate the diagnostic values of myocardial blood flow (MBF), myocardial flow reserve (MFR) and relative flow reserve (RFR) obtained with low-dose dynamic CZT SPECT for patients with suspected or known coronary artery disease (CAD). Fifty-seven consecutive patients who underwent low-dose dynamic CZT SPECT and CAG were enrolled. MBF, MFR and RFR were calculated on the vessel level with dedicated quantitative software, and the difference and correlation of each parameter was compared according to the reference standard of stenosis ≥ 50% or ≥ 75% on CAG, respectively. ROC curves were made by stress MBF (sMBF), rest MBF (rMBF), MFR and RFR. The optimal cut-off values and corresponding diagnostic efficacy were obtained and compared with each other. Results indicated that when stenosis ≥ 50% or ≥ 75% on CAG was used as the reference standard at the vessel level, there was no statistically significant difference in rMBF between the negative group and the positive group (P > 0.05), and the sMBF and MFR in positive groups were significantly lower than that in the negative group (all P < 0.05). There was a moderate to significant correlation between sMBF and MFR, sMBF and RFR, MFR and RFR (all P < 0.0001). These results indicate that low-dose dynamic CZT SPECT imaging can easily obtain the sMBF, MFR and RFR, and there is a good correlation among the three parameters, which has a certain diagnostic value for patients with suspected or known CAD, and is a useful supplement to the conventional qualitative or semi-quantitative diagnostic methods.

摘要

本研究旨在探讨和评估低剂量动态 CZT SPECT 检测心肌血流(MBF)、心肌血流储备(MFR)和相对血流储备(RFR)对疑似或已知冠心病(CAD)患者的诊断价值。连续纳入 57 例接受低剂量动态 CZT SPECT 和 CAG 的患者。应用专用定量软件对血管水平的 MBF、MFR 和 RFR 进行计算,并根据 CAG 上狭窄程度≥50%或≥75%的参考标准,比较各参数的差异和相关性。绘制了应激 MBF(sMBF)、静息 MBF(rMBF)、MFR 和 RFR 的 ROC 曲线。获得了最佳截断值和相应的诊断效能,并进行了比较。结果表明,当 CAG 上狭窄程度≥50%或≥75%作为血管水平的参考标准时,阴性组和阳性组之间 rMBF 无统计学差异(P>0.05),而阳性组的 sMBF 和 MFR 明显低于阴性组(均 P<0.05)。sMBF 与 MFR、sMBF 与 RFR、MFR 与 RFR 之间存在中度至显著相关性(均 P<0.0001)。这些结果表明,低剂量动态 CZT SPECT 成像可以方便地获得 sMBF、MFR 和 RFR,且三者之间具有良好的相关性,对疑似或已知 CAD 患者具有一定的诊断价值,是传统定性或半定量诊断方法的有益补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/010a/7878253/fe227d2c411f/10554_2020_1962_Fig1_HTML.jpg

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