De Bello V, Bellina C R, Molea N, Talarico L, Boni G, Magagnini E, Matteucci F, Giorgi D, Lazzeri E, Bertini A, Romano M F, Bianchi R, Giusti C
2nd Institute of Clinical Medicine, University of Pisa, Italy.
Int J Card Imaging. 1996 Sep;12(3):185-90. doi: 10.1007/BF01806221.
Simultaneous dobutamine stress echocardiography (DSE) and 99Tc-MIBI-SPET (DMS) for the evaluation of the presence and the extent of coronary artery disease (CAD) were assessed for a head to head comparison regarding the diagnostic acuracy of the two rests.
Forty-five consecutive patients (33 males and 12 females: 53 +/- 6.8 yr.) underwent exercise electrocardiography and simultaneous dobutamine stress echocardiography and MIBI-SPET imaging. Coronary angiography was performed in all patients (significant coronary stenosis > 50%). On the basis of the results of exercise electrocardiogram the pre-test probability for coronary artery disease (Diamond's algorithm) was low (45.6 +/- 12.7%). The overall specificity, sensitivity and predictive accuracy of Echo-dobutamine stress test for diagnosis of the presence or absence of CAD were: specificity 82%, sensitivity 76%, diagnostic accuracy 80%, positive predictive value 90%, negative predictive value 40%. The overall specificity, sensitivity and predictive accuracy of MIBI-SPET-dobutamine test for diagnosis of the presence or absence of CAD were: specificity 86%, sensitivity 87%, diagnostic accuracy 84%, positive predictive value 97%, negative predictive value 54%. MIBI-SPET-dobutamine test showed a significantly higher sensitivity in comparison with ECHO-dobutamine test (P < 0.05).
Both noninvasive methods for the detection of CAD showed a good diagnostic accuracy. Nevertheless the SPET model showed a higher sensitivity in comparison with DSE model, essentially in the presence of a lower extent of CAD and during submaximal test.
对用于评估冠状动脉疾病（CAD）的存在及范围的同时进行的多巴酚丁胺负荷超声心动图（DSE）和99Tc-MIBI单光子发射计算机断层显像（DMS）就两种检查的诊断准确性进行了直接比较评估。
连续45例患者（33例男性和12例女性：年龄53±6.8岁）接受了运动心电图检查以及同时进行的多巴酚丁胺负荷超声心动图和MIBI-SPET成像检查。所有患者均进行了冠状动脉造影（冠状动脉显著狭窄>50%）。根据运动心电图结果，冠状动脉疾病的预测试概率（钻石算法）较低（45.6±12.7%）。多巴酚丁胺负荷超声心动图用于诊断CAD存在与否的总体特异性、敏感性和预测准确性分别为：特异性82%，敏感性76%，诊断准确性80%，阳性预测值90%，阴性预测值40%。MIBI-SPET-多巴酚丁胺检查用于诊断CAD存在与否的总体特异性、敏感性和预测准确性分别为：特异性86%，敏感性87%，诊断准确性84%，阳性预测值97%，阴性预测值54%。与多巴酚丁胺负荷超声心动图检查相比，MIBI-SPET-多巴酚丁胺检查显示出显著更高的敏感性（P<0.05）。
两种检测CAD的非侵入性方法均显示出良好的诊断准确性。然而，与DSE模型相比，SPET模型显示出更高的敏感性，主要是在CAD程度较低以及次极量检查期间。
