Department of Cardiology, Nihon University Hospital.
Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
Circ J. 2022 Aug 25;86(9):1409-1415. doi: 10.1253/circj.CJ-21-0739. Epub 2022 Apr 20.
The diagnostic accuracy of stress myocardial perfusion single-photon emission computed tomography (SPECT) to detect coronary artery disease (CAD) is reduced by the balanced reduction of myocardial perfusion in patients with multi-vessel or left main trunk CAD (multi-vessel group). This study investigated the diagnostic performance of a simultaneous acquisition rest Tc/stress Tl dual-isotope protocol for myocardial perfusion SPECT (MPS) in a multi-vessel group by examining the assessment of a slow Tl washout rate (WR) finding in comparison to the accuracy of perfusion assessments.
This study enrolled 91 patients who had undergone angiography within 3 months after MPS. The diagnostic performances of perfusion assessments and a slow Tl WR parameter were compared using the area under the curve (AUC) in a multi-vessel group of patients with mild ischemia (2≤summed difference score [SDS]≤7). The AUC of a slow WR parameter was significantly larger compared with that for perfusion assessments, in patients with mild ischemia, (AUC, 0.736 vs. 0.504-0.558, P value: <0.01-0.05).
Among patients with mild ischemia, a slow Tl WR parameter improved the detection of CAD in a multi-vessel group.
在多血管病变或左主干病变（多血管病变组）患者中，心肌灌注单光子发射计算机断层扫描（SPECT）的诊断准确性因心肌灌注的平衡减少而降低。本研究通过检查 Tl 洗脱率（WR）缓慢发现的评估与灌注评估的准确性相比，研究了同时采集静息 Tc/应激 Tl 双同位素方案用于心肌灌注 SPECT（MPS）在多血管病变组中的诊断性能。
本研究纳入了 91 例在 MPS 后 3 个月内行血管造影的患者。使用曲线下面积（AUC）比较了轻度缺血（2≤总和差异评分[SDS]≤7）患者的灌注评估和缓慢 Tl WR 参数的诊断性能。在轻度缺血患者中，缓慢 WR 参数的 AUC 明显大于灌注评估的 AUC（AUC，0.736 比 0.504-0.558，P 值：<0.01-0.05）。
在轻度缺血患者中，缓慢 Tl WR 参数提高了多血管病变组中 CAD 的检出率。
