IQ-SPECT和LEHR-SPECT心肌灌注显像对冠心病诊断价值的对比研究
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摘要
目的:探讨IQ-SPECT和低能量高分辨率(LEHR)准直器SPECT(LEHR-SPECT)心肌灌注显像对冠心病诊断价值的差异。方法:对临床科室推送的100例疑似冠心病且已进行冠状动脉造影检查的患者,进行IQ-SPECT和LEHR-SPECT心肌灌注显像。以冠状动脉造影为"金标准",对比IQ-SPECT和LEHR-SPECT心肌灌注显像诊断冠心病的灵敏度、特异度和准确率,并对数据进行x~2检验。结果:以冠状动脉管腔狭窄>50%为诊断标准,100例患者中冠状动脉造影阳性41例(占41%)。冠状动脉造影阳性的患者中IQ-SPECT心肌灌注显像阳性27例,LEHR-SPECT心肌灌注显像阳性25例;冠状动脉造影阴性患者59例(占59%),IQ-SPECT心肌灌注显像阴性55例,LEHR-SPECT心肌灌注显像阴性55例。对照冠状动脉造影的检查结果,IQ-SPECT心肌灌注显像对冠心病诊断的灵敏度为66%(27/41),特异度为93%(55/59),准确率为82%(82/100),LEHR-SPECT心肌灌注显像对冠心病诊断的灵敏度为61%(25/41),特异度为93%(55/59),准确率为80%(80/100)。IQ-SPECT心肌灌注显像对冠心病诊断的灵敏度高于LEHR-SPECT心肌灌注显像,但两者相比差异无统计学意义(x~2=7.657,P>0.05)。结论:IQ-SPECT和LEHR-SPECT心肌灌注显像对冠心病的诊断价值具有较好的一致性。
Objective: To investigate the difference of diagnostic values of myocardial perfusion imaging between IQSPECT and LEHR-SPECT for coronary heart disease. Methods: IQ-SPECT and LEHR-SPECT myocardial perfusion imaging were performed in 100 patients with suspected coronary artery disease who have undergone coronary angiography in clinical departments. The coronary angiography was used as the "gold standard", and the sensitivity, specificity and accuracy of myocardial perfusion imaging of IQ-SPECT and LEHR-SPECT in the diagnosis of coronary heart disease were compared, and those data were analyzed by using x~2 test. Results: When the coronary artery stenosis was more than 50% was adopted as the diagnosis standard, there were 41 cases(41%) were positive coronary arteriography in 100 patients. And in the positive patients, there were 27 cases were positive myocardial perfusion imaging of IQ-SPECT, and 25 cases were positive myocardial perfusion imaging of LEHR-SPECT. On the other hand, there were 59 cases(59%) were negative coronary arteriography in 100 patients, and there were 55 cases were negative myocardial perfusion imaging of IQ-SPECT and 55 cases were negative myocardial perfusion imaging of LEHR-SPECT in the 59 cases, respectively. Compared with the results of coronary arteriography, the diagnostic sensitivity of myocardial perfusion imaging of IQ-SPECT for coronary heart disease was 66%(27/41), and its specificity and accuracy were 93%(55/59) and 82%(82/100), respectively. And the diagnostic sensitivity, specificity and accuracy of myocardial perfusion imaging of LEHR-SPECT for coronary heart disease were 61%(25/41), 93%(55/59) and 80%(80/100), respectively. Besides, the diagnostic sensitivity of IQ-SPECT myocardial perfusion imaging were not significantly higher than that of LEHR-SPECT myocardial perfusion imaging(x~2=7.657, P>0.05). Conclusion: The diagnostic values of myocardial perfusion imaging of IQ-SPECT and LEHR-SPECT for coronary heart disease have good consistency.
Objective: To investigate the difference of diagnostic values of myocardial perfusion imaging between IQSPECT and LEHR-SPECT for coronary heart disease. Methods: IQ-SPECT and LEHR-SPECT myocardial perfusion imaging were performed in 100 patients with suspected coronary artery disease who have undergone coronary angiography in clinical departments. The coronary angiography was used as the "gold standard", and the sensitivity, specificity and accuracy of myocardial perfusion imaging of IQ-SPECT and LEHR-SPECT in the diagnosis of coronary heart disease were compared, and those data were analyzed by using x~2 test. Results: When the coronary artery stenosis was more than 50% was adopted as the diagnosis standard, there were 41 cases(41%) were positive coronary arteriography in 100 patients. And in the positive patients, there were 27 cases were positive myocardial perfusion imaging of IQ-SPECT, and 25 cases were positive myocardial perfusion imaging of LEHR-SPECT. On the other hand, there were 59 cases(59%) were negative coronary arteriography in 100 patients, and there were 55 cases were negative myocardial perfusion imaging of IQ-SPECT and 55 cases were negative myocardial perfusion imaging of LEHR-SPECT in the 59 cases, respectively. Compared with the results of coronary arteriography, the diagnostic sensitivity of myocardial perfusion imaging of IQ-SPECT for coronary heart disease was 66%(27/41), and its specificity and accuracy were 93%(55/59) and 82%(82/100), respectively. And the diagnostic sensitivity, specificity and accuracy of myocardial perfusion imaging of LEHR-SPECT for coronary heart disease were 61%(25/41), 93%(55/59) and 80%(80/100), respectively. Besides, the diagnostic sensitivity of IQ-SPECT myocardial perfusion imaging were not significantly higher than that of LEHR-SPECT myocardial perfusion imaging(x~2=7.657, P>0.05). Conclusion: The diagnostic values of myocardial perfusion imaging of IQ-SPECT and LEHR-SPECT for coronary heart disease have good consistency.
引文
[1]周翠红,王猛,金超岭,等.IQ-SPECT和LEHR-SPECT心肌灌注显像的模型研究[J].中国医学装备,2016,13(6):50-52.
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[6]许英杰,曹文田,王荣福,等.心肌SPECT灌注显像的心脏轴向移动校正[J].中国医学影像技术,2012,28(12):2252-2256.
[7]Caobelli F,Pizzocaro C,Paghera B,et al.Evaluation of patients with coronary artery disease.IQ-SPECTprotocol in myocardial perfusion imaging:Preliminary results[J].Nuklearmedizin,2013,52:178-185.
[8]Assuero Giorgetti,Pier Giorgio Masci,Gavino Marras,et al.Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol:comparison to cardiac magnetic resonance imaging[J].Eur JNucl Med Mol Imaging,2013,40:1869-1875.
[9]Cochet H,Bullier E,Gerbaud E,et al.Absolute quantification of left ventricular global and regional function at nuclear MPI using ultrafast CZT SPECT:initial validation versus cardiac MR[J].Nucl Med,2013,54(4):556-563.
[10]Garcia EV,Faber TL,Esteves FP.Cardiac dedicated ultrafast SPECT cameras:new designs and clinical implications[J].J Nucl Med,2011,52:210-217.
[11]Horiguchi Y,Ueda T,Shiomori T,et al.Validation of short-scan-time imaging protocol for thallium-201 myocardial SPECT with a multifocal collimator[J].Ann Nucl Med,2014,28:707-715.
[12]Laetitia Imbert,Sylvain Poussier,Philippe R,et al.Compared Performance of High-Sensitivity Cameras Dedicated to Myocardial Perfusion SPECT:A Comprehensive Analysis of Phantom and Human Images[J].J Nucl Med,2012,53:1897-1903.
[13]袁婷婷,王荣福.核素心肌显像技术的研究进展[J].中国医学装备,2017,14(4):17-20.
[2]王猛,周翠红,金超岭,等.IQ·SPECT和LEHR·SPECT心肌模型显像研究[J].中国医疗设备,2015,30(11):47-49.
[3]Duvall WL,Croft LB,Ginsberg ES,et al.Reduced isotope dose and imaging time with a high efficiency CZT SPECT camera[J].J Nucl Cardiol,2011,18:847-857.
[4]赵德善,张承刚.SPECT与γ照相机质量控制及参考规程[M].北京:人民卫生出版社,2010.
[5]范向勇,周献锋,马加一.SPECT质量控制检测探讨[J].中国医学装备,2014,11(3):8-9.
[6]许英杰,曹文田,王荣福,等.心肌SPECT灌注显像的心脏轴向移动校正[J].中国医学影像技术,2012,28(12):2252-2256.
[7]Caobelli F,Pizzocaro C,Paghera B,et al.Evaluation of patients with coronary artery disease.IQ-SPECTprotocol in myocardial perfusion imaging:Preliminary results[J].Nuklearmedizin,2013,52:178-185.
[8]Assuero Giorgetti,Pier Giorgio Masci,Gavino Marras,et al.Gated SPECT evaluation of left ventricular function using a CZT camera and a fast low-dose clinical protocol:comparison to cardiac magnetic resonance imaging[J].Eur JNucl Med Mol Imaging,2013,40:1869-1875.
[9]Cochet H,Bullier E,Gerbaud E,et al.Absolute quantification of left ventricular global and regional function at nuclear MPI using ultrafast CZT SPECT:initial validation versus cardiac MR[J].Nucl Med,2013,54(4):556-563.
[10]Garcia EV,Faber TL,Esteves FP.Cardiac dedicated ultrafast SPECT cameras:new designs and clinical implications[J].J Nucl Med,2011,52:210-217.
[11]Horiguchi Y,Ueda T,Shiomori T,et al.Validation of short-scan-time imaging protocol for thallium-201 myocardial SPECT with a multifocal collimator[J].Ann Nucl Med,2014,28:707-715.
[12]Laetitia Imbert,Sylvain Poussier,Philippe R,et al.Compared Performance of High-Sensitivity Cameras Dedicated to Myocardial Perfusion SPECT:A Comprehensive Analysis of Phantom and Human Images[J].J Nucl Med,2012,53:1897-1903.
[13]袁婷婷,王荣福.核素心肌显像技术的研究进展[J].中国医学装备,2017,14(4):17-20.