CAJ | 학술논문

目的研究基于西方人群的核素心肌灌注显像(MPI)定量分析技术应用于本地人群时对冠心病的诊断准确性.方法 (1)选择72例3个月内同期行冠状动脉造影(CAG)和MPI的患者为试验组;(2)在Cedars quantitative perfusion SPECT(QPS)软件平台上,建立QPS简单法数据库,从140例冠心病可能性＜5%、已行两日法99Tcm-甲氧基异丁基异腈(MIBI)MPI的患者中选择80例建立本地人正常MPI数据库;(3)采用2种西方人正常MPI数据库(分别为数据库1和数据库2)和本地人正常MPI数据库,对试验组患者的MPI图像进行定量分析,并与目测法结果进行比较.均数间比较采用t检验,受试者工作特征(ROC)曲线下面积(AUC)比较采用z检验.结果数据库2和本地人正常MPI数据库对试验组患者的MPI进行定量分析显示,缺血总范围(EXT)分别为(10.73±14.54)%和(14.22±16.51)%(t=7.87,P＜0.001),缺血总严重程度(SEV)分别为1.07±0.93和1.34±1.20(t=7.45,P＜0.001).以EXT为定量诊断参数时,本地人正常MPI数据库所得AUG为0.85±0.05,与数据库1(0.72±0.06,z=2.50,P＜0.01)和数据库2(0.77±0.06,z=2.47,P＜0.01)的AUC比较,差异均有统计学意义,但与目测半定量法负荷总积分(V-SSS)作为诊断参数的AUC(0.83±0.05)相比差异无统计学意义(z=0.05,P＞0.05).结论以西方人正常MPI数据库为基础的定量分析技术应用于本地人群时会低估患者的心肌缺血面积和严重程度,会降低对冠心病诊断的准确性.
목적 연구기우서방인군적핵소심기관주현상(MPI)정량분석기술응용우본지인군시대관심병적진단준학성.방법 (1)선택72례3개월내동기행관상동맥조영(CAG)화MPI적환자위시험조;(2)재Cedars quantitative perfusion SPECT(QPS)연건평태상,건립QPS간단법수거고,종140례관심병가능성＜5%、이행량일법99Tcm-갑양기이정기이정(MIBI)MPI적환자중선택80례건립본지인정상MPI수거고;(3)채용2충서방인정상MPI수거고(분별위수거고1화수거고2)화본지인정상MPI수거고,대시험조환자적MPI도상진행정량분석,병여목측법결과진행비교.균수간비교채용t검험,수시자공작특정(ROC)곡선하면적(AUC)비교채용z검험.결과 수거고2화본지인정상MPI수거고대시험조환자적MPI진행정량분석현시,결혈총범위(EXT)분별위(10.73±14.54)%화(14.22±16.51)%(t=7.87,P＜0.001),결혈총엄중정도(SEV)분별위1.07±0.93화1.34±1.20(t=7.45,P＜0.001).이EXT위정량진단삼수시,본지인정상MPI수거고소득AUG위0.85±0.05,여수거고1(0.72±0.06,z=2.50,P＜0.01)화수거고2(0.77±0.06,z=2.47,P＜0.01)적AUC비교,차이균유통계학의의,단여목측반정량법부하총적분(V-SSS)작위진단삼수적AUC(0.83±0.05)상비차이무통계학의의(z=0.05,P＞0.05).결론 이서방인정상MPI수거고위기출적정량분석기술응용우본지인군시회저고환자적심기결혈면적화엄중정도,회강저대관심병진단적준학성.
Objective To evaluate the accuracy of automated quantification of myocardial perfusion imaging (MPI) using a method based on a Western normal database for the detection of coronary artery disease (CAD) in a group of Chinese patients. Methods Seventy-two Chinese patients who underwent coronary angiography (CAG) and MPI within 3 months were recruited into this study. Eighty selected from 140 Chinese patients with low probability of CAD ( ＜ 5% ) were enrolled into local normal database of 99Tcm-methoxyisobutylisonitrile (MIBI) MPI using Cedars quantitative perfusion SPECT (QPS) database. Two Western MPI normal databases (CSMC MibiMbiAuto and Mibimibi) were used for processing the Chinese CAD patients recruited in this study, and the results were compared with those using local normal database and visual interpretation. T-test and z-test were used for statistical analysis. Results The extent (EXT)measurement obtained from Mibimibi and local database was ( 10.73 ± 14.54)% and ( 14.22 ± 16.51 )%,respectively ( t = 7.87, P ＜ 0.001 ); the severity (SEV) was 1.07 ± 0.93 and 1.34 ± 1.20, respectively ( t =7.45, P＜0.001). The area under curve(AUC) by using EXT measurement for local database (0.85 ±0.05) was larger than that for CSMC MibiMbiAuto ( AUC = 0.72 ± 0.06, z = 2.50, P ＜ 0.01 ) and Mibimibi ( AUC = 0.77 ± 0.06, z = 2.47, P = 0.014). The AUC of local database showed no significant difference from that of visual interpretation (AUC=0.83 ±0.05, z=0.05, P＞0.05). Conclusion Quantification of MPI of our Chinese patients using Western normal database would decrease the accuracy for the detection of CAD.