中国医学影像技术
中國醫學影像技術
중국의학영상기술
CHINESE JOURNAL OF MEDICAL IMAGING TECHNOLOGY
2009年
10期
1883-1887
,共5页
郑泓明%陈英敏%冯珏%方风宁
鄭泓明%陳英敏%馮玨%方風寧
정홍명%진영민%풍각%방풍저
冠状动脉造影成像%心肌灌注显像%冠状动脉疾病%心肌缺血%体层摄影术%X线计算机
冠狀動脈造影成像%心肌灌註顯像%冠狀動脈疾病%心肌缺血%體層攝影術%X線計算機
관상동맥조영성상%심기관주현상%관상동맥질병%심기결혈%체층섭영술%X선계산궤
Coronary angiography%Myocardial perfusion imaging%Coronary disease%Myocardial ischemia%Tomography%X-ray computed
目的 利用~(99m)Tc-MIBI心肌灌注显像(MPI)探讨64排螺旋CT冠状动脉造影(CTCA)发现的冠状动脉狭窄对心肌缺血的诊断效能.方法 30例患者接受MPI和CTCA检查.将CTCA三支冠状动脉分为12段,以MPI为诊断标准,分别以CTCA血管狭窄≥50%和≥75%为截断值,统计对应节段MPI是否出现异常,分析CTCA诊断的冠状动脉狭窄对心肌缺血的效能评价.结果 MPI发现灌注异常9例(6例可逆性,3例固定性血流灌注减低).CTCA共分析327个冠状动脉节段,其中狭窄≥50%者占25段(7.65%);狭窄≥75%者12段(3.67%).以MPI异常为标准观察病变血管,以狭窄≥50%为界值时,CTCA的敏感性、特异性、阴性预测值(NPV)、阳性预测值(PPV)和准确性分别是68.42%、96.14%、99.01%、52.00%和95.41%;以狭窄≥75%为界值,则分别为66.67%、99.04%、98.73%、66.67%、97.55%.以MPI异常为标准观察患者,当血管狭窄≥50%为界值时,CTCA 的敏感性、特异性、NPV、PPV和准确性分别是66.67%、57.14%、80.00%、40.00%和60.00%;当≥75%为界值时,上述指标分别是55.56%、85.71%、81.82%、62.50%和76.67%.结论 正常CTCA对心肌缺血患者的排查是可靠的,CTCA异常是否存在心肌缺血需要进一步检查.
目的 利用~(99m)Tc-MIBI心肌灌註顯像(MPI)探討64排螺鏇CT冠狀動脈造影(CTCA)髮現的冠狀動脈狹窄對心肌缺血的診斷效能.方法 30例患者接受MPI和CTCA檢查.將CTCA三支冠狀動脈分為12段,以MPI為診斷標準,分彆以CTCA血管狹窄≥50%和≥75%為截斷值,統計對應節段MPI是否齣現異常,分析CTCA診斷的冠狀動脈狹窄對心肌缺血的效能評價.結果 MPI髮現灌註異常9例(6例可逆性,3例固定性血流灌註減低).CTCA共分析327箇冠狀動脈節段,其中狹窄≥50%者佔25段(7.65%);狹窄≥75%者12段(3.67%).以MPI異常為標準觀察病變血管,以狹窄≥50%為界值時,CTCA的敏感性、特異性、陰性預測值(NPV)、暘性預測值(PPV)和準確性分彆是68.42%、96.14%、99.01%、52.00%和95.41%;以狹窄≥75%為界值,則分彆為66.67%、99.04%、98.73%、66.67%、97.55%.以MPI異常為標準觀察患者,噹血管狹窄≥50%為界值時,CTCA 的敏感性、特異性、NPV、PPV和準確性分彆是66.67%、57.14%、80.00%、40.00%和60.00%;噹≥75%為界值時,上述指標分彆是55.56%、85.71%、81.82%、62.50%和76.67%.結論 正常CTCA對心肌缺血患者的排查是可靠的,CTCA異常是否存在心肌缺血需要進一步檢查.
목적 이용~(99m)Tc-MIBI심기관주현상(MPI)탐토64배라선CT관상동맥조영(CTCA)발현적관상동맥협착대심기결혈적진단효능.방법 30례환자접수MPI화CTCA검사.장CTCA삼지관상동맥분위12단,이MPI위진단표준,분별이CTCA혈관협착≥50%화≥75%위절단치,통계대응절단MPI시부출현이상,분석CTCA진단적관상동맥협착대심기결혈적효능평개.결과 MPI발현관주이상9례(6례가역성,3례고정성혈류관주감저).CTCA공분석327개관상동맥절단,기중협착≥50%자점25단(7.65%);협착≥75%자12단(3.67%).이MPI이상위표준관찰병변혈관,이협착≥50%위계치시,CTCA적민감성、특이성、음성예측치(NPV)、양성예측치(PPV)화준학성분별시68.42%、96.14%、99.01%、52.00%화95.41%;이협착≥75%위계치,칙분별위66.67%、99.04%、98.73%、66.67%、97.55%.이MPI이상위표준관찰환자,당혈관협착≥50%위계치시,CTCA 적민감성、특이성、NPV、PPV화준학성분별시66.67%、57.14%、80.00%、40.00%화60.00%;당≥75%위계치시,상술지표분별시55.56%、85.71%、81.82%、62.50%화76.67%.결론 정상CTCA대심기결혈환자적배사시가고적,CTCA이상시부존재심기결혈수요진일보검사.
Objective To investigate the diagnostic efficiency of 64-slice CT coronary angiography (CTCA) to myocardial ischemia of coronary stenosis. Methods ~(99m) Tc-MIBI myocardial perfusion imaging (MPI) and 64-slice CTCA were performed in 30 patients with myocardial ischemia of coronary stenosis. Three coronary arteries were divided in to 12 segments in each patient, the diagnostic efficiency of CTCA to myocardial ischemia of coronary stenosis were eveluated taking MPI as diagnostic standard, and stenoses ≥50% and ≥75% as the cutoff value. Results In 9 patients, perfusion defected were found (6 reversible, 3 fixed) on MPI. A total of 327 coronary arteries' segments were analyzed, quantitative CTCA revealed stenoses ≥50% in 25 segments (7.65%) and stenoses ≥75% in 12 segments (3.67%). When the cut-off was ≥50%, the sensitivity, specificity, negative and positive predictive value (NPV, PPV) and accuracy of CTCA by the abnormal images of MPI as diagnostic standard to observe abnormal arteries was 68.42%, 96.14%, 99.01%, 52.00% and 95.41%, respectively; and 66.67%, 99.04%, 98.73%, 66.67% and 97.55%, respectively, when cut-off at ≥75%. Taking abnormal MPI as diagnostic standard to observe the patients, the sensitivity, specificity, NPV, PPV and accuracy of CTCA was 66.67%, 57.14%, 80.00%, 40.00% and 60.00% respectively, with the cut-off at ≥50%; and was 55.56%, 85.71%, 81.82%, 62.50% and 76.67%, respectively, with the cut-off at ≥75%.Conclusion Sixty-four-slice CTCA is a reliable tool to rule out functionally relevant myocardial ischemia of coronary artery disease. However, further examination is necessory for patients with abnormal CTCA.
