分子影像学杂志2025，Vol.48Issue(2)：145-151,7.DOI:10.12122/j.issn.1674-4500.2025.02.03
99mTc-MIBI心肌灌注显像联合临床特征的诊断模型可有效预测冠心病
99m Tc-MIBI myocardial imaging combined with clinical features can effectively predict coronary artery disease
摘要
Abstract
Objective To develop a diagnostic prediction model for coronary artery disease(CAD)based on 99mTc-methoxyisobutylisonitrile(MIBI)gated myocardial perfusion imaging(GMPI)and clinical features,and to perform internal validation to assess its utility in predicting the risk of CAD.Methods A retrospective analysis was conducted to collect GMPI parameters and clinical characteristics of 116 patients suspected of having CAD who underwent 99mTc-MIBI SPECT/CT gated myocardial resting perfusion imaging at Zhujiang Hospital of Southern Medical University from January 2023 to November 2023.Among the patients,77 were male and 39 were female,with an age range of 23-93(62.66±12.22)years old.Predictive factors for CAD were identified using stepwise regression and multivariate logistic regression analysis,and a diagnostic prediction model was constructed and presented in the form of a nomogram.The predictive performance of the model was evaluated by calculating the area under the ROC curve(AUC).Internal validation was performed using k-fold cross-validation.The calibration and clinical utility of the model were assessed through calibration curves,decision curve analysis(DCA),and clinical impact curves.Results Stepwise regression analysis identified left ventricular end-diastolic volume,peak filling rate,histogram skewness,and histogram kurtosis among the GMPI parameters as effective diagnostic predictors of CAD.Incorporating clinical characteristics(gender,smoking history,cardiac troponin,hypertension),a predictive model was constructed with an AUC of 0.731(95%CI:0.636-0.825),specificity of 0.735,and sensitivity of 0.642.The average AUC from k-fold cross-validation was 0.699.Calibration curves demonstrated good calibration of the CAD diagnostic prediction model,while decision curve analysis and clinical impact curves indicated its high clinical utility.Conclusion The diagnostic prediction model based on 99mTc-MIBI GMPI parameters and clinical characteristics(gender,smoker,cardiac troponin,hypertension)demonstrates good performance in assessing patients with CAD,offering potential for developing more personalized diagnostic strategies for CAD.关键词
心肌灌注显像/冠心病/预测模型/列线图Key words
myocardial perfusion imaging/coronary artery disease/prediction model/nomogram引用本文复制引用
陈媛,李东,罗晓琴,凌苑娜,欧阳伟..99mTc-MIBI心肌灌注显像联合临床特征的诊断模型可有效预测冠心病[J].分子影像学杂志,2025,48(2):145-151,7.基金项目
国家自然科学基金(82071955)Supported by National Natural Science Foundation of China(82071955). （82071955）
