Roach P J, Hansen P S, Scott A M, Cooper R A, Hoschl R, Wiseman J C, Bernar A, Edwards A C
Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, NSW.
Aust N Z J Med. 1996 Dec;26(6):806-12. doi: 10.1111/j.1445-5994.1996.tb00629.x.
Thallium SPECT has been shown to be more sensitive than planar imaging in the detection of coronary heart disease (CAD) in a number of reported series. Early (< 10 minutes) redistribution on planar imaging has been demonstrated in clinical studies and this may partly contribute to its lower sensitivity.
To determine whether thallium SPECT is superior to planar scintigraphy (with the timing of imaging performed optimally so that it was commenced within five minutes of injection) in the detection of CAD.
Planar and SPECT studies were performed in 44 patients with significant (> 70% stenosis) CAD, seven patients with borderline stenoses (50-69%) and in 18 patients with no significant CAD.
The sensitivity of planar imaging was 66% which was higher than exercise ECG 54% (ns) but significantly lower than SPECT 86% (p < 0.005). The specificity of planar thallium scintigraphy was 100% which was higher than SPECT (83%) and significantly higher than exercise ECG 72% (p < 0.05). SPECT had a significantly higher sensitivity for LAD and single vessel disease than planar imaging and this was unrelated to a history of prior myocardial infarction.
Even when planar imaging is timed optimally to minimise the impact of early redistribution, SPECT is more sensitive than either planar imaging or exercise ECG in the detection of CAD, but its specificity is lower.
在一些已报道的系列研究中，铊单光子发射计算机断层扫描（SPECT）在检测冠心病（CAD）方面已被证明比平面显像更敏感。临床研究已证实平面显像存在早期（<10分钟）再分布，这可能部分导致其敏感性较低。
确定在检测CAD方面，铊SPECT是否优于平面闪烁显像（成像时间进行了优化，以便在注射后五分钟内开始）。
对44例患有严重（>70%狭窄）CAD的患者、7例患有临界狭窄（50 - 69%）的患者以及18例无明显CAD的患者进行了平面和SPECT研究。
平面显像的敏感性为66%，高于运动心电图的54%（无显著差异），但显著低于SPECT的86%（p < 0.005）。平面铊闪烁显像的特异性为100%，高于SPECT的83%，且显著高于运动心电图的72%（p < 0.05）。SPECT对左前降支（LAD）病变和单支血管病变的敏感性显著高于平面显像，且这与既往心肌梗死病史无关。
即使平面显像的时间进行了优化以尽量减少早期再分布的影响，但在检测CAD方面，SPECT比平面显像或运动心电图更敏感，但其特异性较低。
