Mills J A, Flint J, Taylor D N, Delchar T, McIntosh J A, Pilcher J
Br J Radiol. 1985 Jul;58(691):625-34. doi: 10.1259/0007-1285-58-691-625.
A trial was undertaken to compare the diagnostic capabilities of rotating slant-hole tomography and raw scintigraphic planar images for the assessment of ischaemic heart disease and for infarct detection. Twenty patients with coronary artery disease established by arteriography and 29 patients who had suffered acute myocardial infarction as established by ECG and enzyme criteria were imaged, along with ten normal volunteers. Overall sensitivity and specificity figures, as well as Receiver Operating Characteristics (ROC) curves, were obtained. For infarct detection there was a sensitivity of 93% for tomography and 96% for planar imaging while the specificity was 80% for tomography and 95% for planar imaging. This loss of sensitivity and specificity was also apparent in the ROC curves and showed that there was no advantage from the use of rotating slant-hole tomography. For ischaemic heart disease the sensitivities for tomography and planar imaging were 83% and 91% respectively, while the specificities were 83% and 90% respectively. The ROC analysis again showed this reduction in the diagnostic capability of the test. It was concluded that rotating slant-hole tomography was no advantage in the assessment of ischaemic heart disease. Inter-and intra-observer variability was good with consistent responses in more than 90% of cases. No significant improvement was demonstrated in the poor ability of thallium scanning to specify the diseased vessels, and the phenomenon of false defects in the rotating slant-hole tomographic scans of some normal subjects was shown to affect the response of observers significantly.
进行了一项试验，以比较旋转斜孔断层扫描和原始闪烁平面图像在评估缺血性心脏病和检测梗死方面的诊断能力。对20例经血管造影确诊为冠状动脉疾病的患者、29例经心电图和酶学标准确诊为急性心肌梗死的患者以及10名正常志愿者进行了成像。获得了总体敏感性和特异性数据以及受试者工作特征（ROC）曲线。对于梗死检测，断层扫描的敏感性为93%，平面成像的敏感性为96%，而断层扫描的特异性为80%，平面成像的特异性为95%。这种敏感性和特异性的损失在ROC曲线中也很明显，表明使用旋转斜孔断层扫描没有优势。对于缺血性心脏病，断层扫描和平面成像的敏感性分别为83%和91%，而特异性分别为83%和90%。ROC分析再次显示了该检测诊断能力的下降。得出的结论是，旋转斜孔断层扫描在评估缺血性心脏病方面没有优势。观察者间和观察者内的变异性良好，超过90%的病例反应一致。铊扫描在明确病变血管方面能力较差，未显示出显著改善，并且一些正常受试者的旋转斜孔断层扫描中出现的假缺损现象被证明会显著影响观察者的反应。
