Machecourt J, Denis B, Comet M, Wolf J E, Pellet J, Martin-Noël P
Arch Mal Coeur Vaiss. 1980 Jan;73(1):47-52.
154 patients investigated for chest pain underwent 12 lead exercise electrocardiography and also exercise 201-Thallium myocardial scintigraphy performed at coronary angiography. 92 patients had typical angina; in this group the sensitivity and specificity of exercise electrocardiography was good (91% and 86% respectively) and exercise myocardial scintigraphy did not give significantly better results. On the other hand, in cases when exercise electrocardiography was negative (27%) exercise myocardial scintigraphy was positive in 75%. 201-Thallium did not discriminate between ischaemia and necrosis in patients with previous myocardial infarction, ischaemia alone causing hypofixation on basal myocardial scintigraphy. 62 patients had atypical chest pain. The low incidence of coronary artery disease in this group (30%) increases the value of exercise 201-Thallium scintigraphy as it is both more sensitive (59% compared to 21%, p less than 0,05) and more specific than exercise electrocardiography (43% compared to 85%, p less than 0,1). 29% monotruncular lesions had negative exercise electrocardiography and myocardial scintigraphy. However, multivessel and left main coronary disease may be excluded with great probability by a negative exercise 201-Thallium scintigraphy.
154例因胸痛接受检查的患者进行了12导联运动心电图检查，并在冠状动脉造影时进行了运动201铊心肌闪烁显像。92例患者有典型心绞痛；在该组中，运动心电图的敏感性和特异性良好（分别为91%和86%），运动心肌闪烁显像未得出明显更好的结果。另一方面，在运动心电图结果为阴性的病例中（27%），运动心肌闪烁显像阳性率为75%。对于既往有心肌梗死的患者，201铊不能区分缺血和坏死，仅缺血会导致基础心肌闪烁显像出现放射性减低。62例患者有非典型胸痛。该组冠状动脉疾病的低发病率（30%）增加了运动201铊闪烁显像的价值，因为它比运动心电图更敏感（分别为59%和21%，p<0.05）且更具特异性（分别为43%和85%，p<0.1）。29%的单支血管病变运动心电图和心肌闪烁显像结果为阴性。然而，运动201铊闪烁显像结果为阴性则很有可能排除多支血管病变和左主干冠状动脉疾病。
