Acampa W, Cuocolo A, Sullo P, Varrone A, Nicolai E, Pace L, Petretta M, Salvatore M
Nuclear Medicine Center of the National Council of Research, Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy.
J Nucl Cardiol. 1998 May-Jun;5(3):265-74. doi: 10.1016/s1071-3581(98)90128-3.
Technetium 99m-labeled sestamibi and tetrofosmin tomography have shown high diagnostic accuracy in the detection of coronary artery disease (CAD). However, few data are available comparing sestamibi and tetrofosmin imaging in the same patients. The aim of the study was to determine the image quality of the two tracers and to compare the results of exercise sestamibi and tetrofosmin tomography in the same patients.
The results of exercise-rest sestamibi and tetrofosmin myocardial tomography were compared in 32 patients with suspected or known CAD who underwent coronary angiography. Image quality was evaluated subjectively. Regional tracer distribution was visually assessed and quantitatively measured in 22 segments/patient.
At coronary angiography, 7 patients had normal coronary vessels, 11 single-vessel, and 14 multivessel CAD (> or =50% luminal stenosis). Image quality judged visually was comparable with the two tracers. Heart/lung and heart/liver ratios for sestamibi and tetrofosmin were not different. At visual analysis, 68% of the patients with CAD had abnormal findings with sestamibi and 76% with tetrofosmin (p = NS). At quantitative analysis, 92% of the patients with CAD had abnormal findings with sestamibi and 96% with tetrofosmin (p = NS). At both visual and quantitative analyses, sensitivity, specificity, and diagnostic accuracy in the detection of individual stenosed vessels were not different between the two tracers. Moreover, for both tracers sensitivity, specificity, and diagnostic accuracy in the detection of diseased vessels were significantly higher (all p < 0.05) at quantitative compared with visual analysis. Finally, defect size and severity were similar for the two tracers.
Exercise-rest sestamibi and tetrofosmin tomography yielded images of comparable quality and provided similar results in the identification of patients with CAD and in the detection of the individual stenosed coronary vessels.
锝99m标记的 sestamibi 和替曲膦断层扫描在冠状动脉疾病（CAD）检测中显示出较高的诊断准确性。然而，关于在同一患者中比较 sestamibi 和替曲膦成像的数据较少。本研究的目的是确定两种示踪剂的图像质量，并比较同一患者运动 sestamibi 和替曲膦断层扫描的结果。
对32例疑似或已知CAD且接受冠状动脉造影的患者的运动-静息 sestamibi 和替曲膦心肌断层扫描结果进行比较。主观评估图像质量。对每位患者的22个节段进行区域示踪剂分布的视觉评估和定量测量。
冠状动脉造影显示，7例患者冠状动脉血管正常，11例单支血管病变，14例多支血管病变（管腔狭窄≥50%）。视觉判断的两种示踪剂图像质量相当。sestamibi 和替曲膦的心脏/肺和心脏/肝脏比值无差异。视觉分析时，68%的CAD患者 sestamibi 检查有异常发现，76%的患者替曲膦检查有异常发现（p = 无显著性差异）。定量分析时，92%的CAD患者 sestamibi 检查有异常发现，96%的患者替曲膦检查有异常发现（p = 无显著性差异）。在视觉和定量分析中，两种示踪剂在检测单个狭窄血管时的敏感性、特异性和诊断准确性均无差异。此外，对于两种示踪剂，定量分析时检测病变血管的敏感性、特异性和诊断准确性均显著高于视觉分析（所有p < 0.05）。最后，两种示踪剂的缺损大小和严重程度相似。
运动-静息 sestamibi 和替曲膦断层扫描产生的图像质量相当，在识别CAD患者和检测单个狭窄冠状动脉血管方面提供了相似的结果。
