中华医学杂志（英文版）2004，Vol.117Issue(5)：700-705,6.
Comparison of 99m Tc-methoxyisobutylisonitrile myocardial single-photon emission computed tomography and electron beam computed tomography for detecting coronary artery disease in patients with no myocardial infarction
Comparison of 99m Tc-methoxyisobutylisonitrile myocardial single-photon emission computed tomography and electron beam computed tomography for detecting coronary artery disease in patients with no myocardial infarction
姚稚明 1李伟 1屈婉莹 1周诚 2何青 3季福绥3
作者信息
- 1. Department of Nuclear Medicine,Beijing Hospital, Beijing 100730, China
- 2. Department of Radiology,Beijing Hospital, Beijing 100730, China
- 3. Department of Cardiology,Beijing Hospital, Beijing 100730, China
- 折叠
摘要
Abstract
Background Previous studies have compared single-photon emission computed tomography (SPECT) and electron beam computed tomography (EBCT) in detection of coronary artery disease (CAD) in patients with myocardial infarction (MI). The purpose of this study was to compare SPECT with EBCT in detection of CAD in patients with no MI.Methods One hundred and forty-seven patients with suspected CAD underwent stress-rest 99mTc-methoxyisobutylisonitrile (99m Tc-MIBI) myocardial SPECT, cardiac EBCT and coronary angiography (CAG) within one month. Of them, 73 patients (aged 52.6±10.6 years old) with no history of MI were included in this study. Coronary artery calcium (CAC) was defined as a CT value ≥130 HU within the boundary of coronary artery on EBCT. Results There were 35 and 38 patients with or without CAD according to CAG. Ninety-six percent of the patients with abnormal SPECT and CAC had a coronary arteries stenosis ≥50%, and 90.9% patients with normal SPECT and EBCT showed no CAD. The sensitivity of SPECT and EBCT in detection of CAD was comparable, and the specificity of SPECT (92.1%) was significantly higher than that of EBCT (55.3%) (P<0.005). For the detection of individual coronary artery stenosis, both sensitivity and specificity of SPECT (75.0% and 93.7%) were significantly higher than those of EBCT (53.3% and 76.7%) (P<0.025 and P<0.005, respectively). In patients without chest pain, the sensitivity and specificity of SPECT (76.9% and 91.4%) were significantly higher than those of EBCT (23.1% and 69.0%) in detection of a coronary artery stenosis of ≥50% (P<0.01 and P<0.005, respectively). However, in patients with chest pain, both sensitivity and specificity of SPECT were comparable to those of EBCT. In patients ≤45 years old, the sensitivity of SPECT (77.8%) was significantly higher than that of EBCT (27.8%) in assessing a coronary artery stenosis of ≥50% (P<0.005), and the specificity of SPECT was comparable to that of EBCT. In patients >45 years old, the specificity of SPECT (94.3%) was significantly higher than that of EBCT (70.5%) (P<0.005), and the sensitivity of SPECT was comparable to that of EBCT. Conclusion 99m Tc-MIBI myocardial perfusion SPECT has higher accuracy than that of EBCT in detection of CAD in patients without MI.关键词
coronary artery disease/myocardial perfusion SPECT/coronary calcium/electron beam CTKey words
coronary artery disease/myocardial perfusion SPECT/coronary calcium/electron beam CT分类
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姚稚明,李伟,屈婉莹,周诚,何青,季福绥..Comparison of 99m Tc-methoxyisobutylisonitrile myocardial single-photon emission computed tomography and electron beam computed tomography for detecting coronary artery disease in patients with no myocardial infarction[J].中华医学杂志（英文版）,2004,117(5):700-705,6.
