CAJ | 학술논문

目的评价辨99Tcm-甲氧基异丁基异腈(MIBI)与18F-脱氧葡萄糖(FDG)双核素同时采集法心肌显像(DISA SPECT)检测存活心肌的临床价值.方法 21例经彩超检查证实存在左室壁节段运动障碍的冠心病患者,进行DISA SPECT、冠状动脉造影(CAG)及经皮冠状动脉介人治疗(PCI),对所有狭窄病变行完全血运重建术.参照美国超声心动图学会16节段划分法获得心肌各运动异常节段DISA SPECT图像,并对心肌存活情况进行判定.DISA SPECT图像用目测半定量法分析.术后1,3和6个月时复查心脏超声,以冠状动脉血运重建后室壁节段收缩功能改善为判断存活心肌的"金标准",根据诊断试验四格表评价DISA SPECT检测存活心肌的价值.结果 21例冠心病患者共获得符合条件的室壁运动异常节段156个,根据"金标准"判断其中105个为存活心肌,51个为非存活心肌,DISA SPECT检测存活心肌的灵敏度、特异性、阳性预测值、阴性预测值、准确性分别是93.3%(98/105)、82.4%(42/51)、91.6%(98/107)、85.7%(42/49)、89.7%(140/156).结论 DISASPECT目测半定量法检测存活心肌有较高的临床价值.
목적 평개변99Tcm-갑양기이정기이정(MIBI)여18F-탈양포도당(FDG)쌍핵소동시채집법심기현상(DISA SPECT)검측존활심기적림상개치.방법 21례경채초검사증실존재좌실벽절단운동장애적관심병환자,진행DISA SPECT、관상동맥조영(CAG)급경피관상동맥개인치료(PCI),대소유협착병변행완전혈운중건술.삼조미국초성심동도학회16절단화분법획득심기각운동이상절단DISA SPECT도상,병대심기존활정황진행판정.DISA SPECT도상용목측반정량법분석.술후1,3화6개월시복사심장초성,이관상동맥혈운중건후실벽절단수축공능개선위판단존활심기적"금표준",근거진단시험사격표평개DISA SPECT검측존활심기적개치.결과 21례관심병환자공획득부합조건적실벽운동이상절단156개,근거"금표준"판단기중105개위존활심기,51개위비존활심기,DISA SPECT검측존활심기적령민도、특이성、양성예측치、음성예측치、준학성분별시93.3%(98/105)、82.4%(42/51)、91.6%(98/107)、85.7%(42/49)、89.7%(140/156).결론 DISASPECT목측반정량법검측존활심기유교고적림상개치.
Objective Viable myecardium is important to patients with coronary artery diseage.The obiecfive of this study was to evaluate the value of dual-isotope simultaneous acquisition SPECT(DISA SPECT)with 99Tcm-methoxyisobutylisonitrile (MIBI) and 18F-fluorodeoxyglueose (FDG) in detecting viable myocardium(VM).Methods Twenty-one patients with regional wall motion abnomudities(RWMA) based on routine echocardiography underwent DISA-SPECT,coronary angiography and percutaneous coronary intervention(PCI).Imaging and analysis of the left ventrieular myocardial perfusion status were performed according to the 16-segment models proposed by American Society of Echocardiography.The wall motion of every LV segment was observed by echocardiography after 1,3,6 months.The images of DISASPECT were analyzed semi-quantitatively.The"gold standard"for true viability was improvement of wall motion of the vertricular segment after PCI.Results There were 105 viable myocardial segments and 51 non-viable myocardial segments according to the"gold standard"criterion.The sensitivity,specificity.positive predict value,negative predict value and accuracy of DISA-SPECT in detecting viable myoeardium were 93.3%(98/105),82.4%(42/51),91.6%(98/107),85.7%(42/49),89.7%(140/156),respectively.Conclusion DISA-SPECT is a valuable technique to detect viable myocardium in patients with coronary artery disease.