Yang Xiaoyu, Zhang Feifei, Chen Yongjun, Shao Xiaoliang, Wang Jianfeng, Zhang Sheng, Shi Guiliang, Yang Minfu, Wu Zhifang, Li Sijin, Wang Yuetao
Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, No.185, Juqian Street, Changzhou, 213003, Jiangsu Province, China.
J Nucl Cardiol. 2023 Feb;30(1):214-226. doi: 10.1007/s12350-022-03068-4. Epub 2022 Aug 1.
This study aimed to determine the clinical value of rest F-FDG imaging in Chinese patients with non-acute chest pain, normal ECG, negative troponin, and suspected UA.
136 patients were prospectively included and underwent rest F-FDG PET imaging and coronary arteriography within 1 week.
Obstructive CAD was diagnosed in 71 patients, and stenosis ≥ 70% was confirmed in 130 vascular territories. At patients and vascular level, rest F-FDG imaging showed sensitivity of 62.0%, 47.7%, specificity of 92.3%, 94.2%, accuracy of 76.5%, 79.4%, PPV of 89.8% and 79.5%, and NPV of 69.0% and 79.4%. The AUCs were 0.771 and 0.710. Of 71 patients with obstructive CAD, rest F-FDG imaging showed sensitivity of 47.7% and 58.8%, specificity of 91.6% and 91.2%, accuracy of 64.8% and 80.4%, PPV of 89.9% and 76.9% and NPV of 52.8% and 81.6% in all vascular level and single-vessel disease. In patients with two- or three-vessel disease, rest F-FDG imaging had a diagnostic sensitivity, specificity, accuracy, PPV, and NPV of 43.8%, 93.3%, 50.5%, 97.7%, and 20.6%. The AUCs were 0.696, 0.750, and 0.685.
Rest F-FDG imaging performed certain overall diagnostic efficiency for obstructive CAD in Chinese patients with suspected UA, especially the excellent high PPV in identifying culprit ischemic territory in patients with multivessel disease.
本研究旨在确定静息态F-FDG成像在中国非急性胸痛、心电图正常、肌钙蛋白阴性且疑似不稳定型心绞痛（UA）患者中的临床价值。
前瞻性纳入136例患者，并在1周内进行静息态F-FDG PET成像和冠状动脉造影。
71例患者被诊断为阻塞性冠状动脉疾病（CAD），130个血管区域确认存在≥70%的狭窄。在患者和血管层面，静息态F-FDG成像显示敏感性分别为62.0%、47.7%，特异性分别为92.3%、94.2%，准确性分别为76.5%、79.4%，阳性预测值（PPV）分别为89.8%和79.5%，阴性预测值（NPV）分别为69.0%和79.4%。曲线下面积（AUC）分别为0.771和0.710。在71例阻塞性CAD患者中，静息态F-FDG成像在所有血管层面和单支血管病变中显示敏感性分别为47.7%和58.8%，特异性分别为91.6%和91.2%，准确性分别为64.8%和80.4%，PPV分别为89.9%和76.9%，NPV分别为52.8%和81.6%。在双支或三支血管病变患者中，静息态F-FDG成像的诊断敏感性、特异性、准确性、PPV和NPV分别为43.8%、93.3%、50.5%、97.7%和20.6%。AUC分别为0.696、0.750和0.685。
静息态F-FDG成像对中国疑似UA患者的阻塞性CAD具有一定的总体诊断效率，尤其是在识别多支血管病变患者的罪犯缺血区域方面具有出色的高PPV。
