铊闪烁扫描术在冠状动脉疾病中的预测价值。

Predictive value of thallium scintigraphy in coronary artery disease.

作者信息

Schicha H, Rentrop P, Facorro L, Karsch K R, Blanke H, Kreuzer H, Emrich D

出版信息

Clin Cardiol. 1980 Jun;3(3):184-7. doi: 10.1002/clc.4960030305.

Abstract

To verify the predictive value of thallium exercise scintigraphy, 20 normal individuals and 60 patients with coronary artery disease (CAD) were examined, using a quantitative standard technique and receiver operating characteristic analysis. The sensitivity of thallium scintigraphy for the presence of CAD was 97% for patients with previous infarction and 85% for those without infarction. The sensitivity for the extent of CAD was 93% for vessels perfusing infarcted areas and only 67% for vessels without infarction. In patients without myocardial infarction, sensitivity for the number of diseased vessels decreased with increasing extent of CAD. An underestimation of hemodynamically significant stenoses was proven by a comparison with the results of exercise ventriculography. The predictive value of a normal scintigram at a high prevalence of CAD is as low as the predictive value of an abnormal scintigram at a low prevalence level (screening). Thallium scintigraphy is indicated in patients with a medium prevalence of CAD, e.g., in patients with atypical angina and in asymptomatic patients with pathologic ECG.

摘要

为验证铊运动闪烁扫描术的预测价值，采用定量标准技术和受试者操作特征分析，对20名正常个体和60例冠状动脉疾病（CAD）患者进行了检查。对于既往有心肌梗死的患者，铊闪烁扫描术检测CAD的敏感性为97%，对于无梗死的患者为85%。对于CAD范围的敏感性，灌注梗死区域血管的为93%，未梗死血管的仅为67%。在无心肌梗死的患者中，病变血管数量的敏感性随CAD范围增加而降低。与运动心室造影结果比较证实，血流动力学显著狭窄存在低估情况。在CAD高患病率时正常闪烁扫描图的预测价值与在低患病率水平（筛查）时异常闪烁扫描图的预测价值一样低。铊闪烁扫描术适用于CAD患病率中等的患者，如非典型心绞痛患者和心电图异常的无症状患者。