| 引用本文： |
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张 涵,秦珊珊,樊 鑫,等.D-SPECT在冠心病患者早期诊断和心功能评估中的价值[J].同济大学学报（医学版）,2019,40(2):152-156. [点击复制]
- ZHANG Han,QIN Shan-shan,FAN Xin,et al.Value of D-SPECT in early diagnosis and cardiac function assessment for patients with coronary heart disease[J].同济大学学报（医学版）,2019,40(2):152-156. [点击复制]
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| 摘要: |
| 目的 探讨新型心脏专用机D-SPECT对冠心病（coronary artery disease, CAD）患者心肌缺血部位的定位准确性与评价心功能参数的价值。方法 回顾性分析2017年7月—2018年7月55例拟诊的CAD患者，所有患者均同时行冠状动脉造影（coronary angiography, CAG）及核素心肌灌注显像（myocardial perfusion imaging, MPI），以CAG检查结果为金标准，以门控心肌断层软件（QGS/QPS）测量左室射血分数（left ventricular ejection fraction, LVEF），同时按左心室心肌17节段命名法划分心肌，分析D-SPECT定位CAD患者心肌缺血部位的准确性，比较不同心肌缺血面积患者LVEF的变化。结果 在本组拟诊的55例CAD患者中，CAG与D-SPECT缺血部位一致的例数为39例，一致率为71.0%,D-SPECT诊断心肌缺血的灵敏度为90.6%，特异度为83.3%，准确率为89.0%，两种检查方法结果无明显差异（P＞0.05）。同时，经回归曲线分析显示，心肌缺血面积扩大与LVEF下降具有较强的相关性,心肌缺血面积越大，静息LVEF（R2=0.962）及负荷LVEF（R2=0.948）越小，差异有统计学意义（P＜0.05）。结论 D-SPECT在可较准确的定位心肌缺血部位，并且可以准确提供各种心脏风险因子，为CAD患者早期诊断和预后提供较大的帮助。 |
| 关键词: D-SPECT 冠心病 心肌灌注显像 左心室射血分数 |
| DOI：10.16118/j.1008-0392.2019.02.004 |
| 投稿时间：2018-11-04 |
| 基金项目:国家重点研发计划子课题（2016YFC0104303）；上海市人才发展基金（2017103） |
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| Value of D-SPECT in early diagnosis and cardiac function assessment for patients with coronary heart disease |
| ZHANG Han,QIN Shan-shan,FAN Xin,ZHANG Jia-jia,YIN Yu-zhen,YU Fei |
| (Dept. of Nuclear Medicine, Tenth People’s Hospital, Tongji University, Shanghai 200072, China) |
| Abstract: |
| Objective To assess the value of dynamic single-photon emission computed tomography(D-SPECT) in diagnosis and evaluating cardiac function of patients with coronary heart disease. Methods Clinical data of 55 patients with suspected coronary heart disease admitted in our hospital from July 2017 to July 2018 were retrospectively analyzed. All patients underwent coronary angiography(CAG) and myocardial perfusion imaging（MPI）. The results of coronary angiography were used as the gold standard, left ventricular ejection fraction(LVEF) was measured by gated myocardial tomography software(QGS/QPS), and the left ventricular myocardium was classified according to the 17-segment nomenclature. The accuracy of myocardial ischemia and the changes of LVEF in patients with different myocardial ischemic areas as determined by D-SPECT were analyzed. Results Among 55 patients, CAG and D-SPECT showed the same ischemic location in 39 cases with a coincidence rate of 71.0%. The sensitivity, specificity and accuracy of D-SPECT in the diagnosis of myocardial ischemia were 90.6%, 83.3% and 89.0%, respectively. The regression curve analysis showed that the increase of myocardial ischemic area was closely correlated with the decrease of the rest LVEF(R2=0.962, P<0.05) and the stress LVEF(R2=0.948, P<0.05). Conclusion D-SPECT can accurately locate the myocardial ischemia site and provide various cardiac risk factors, which is of value in diagnosis and prognosis of patients with coronary heart disease. |
| Key words: D-SPECT coronary angiography myocardial perfusion imaging left ventricular ejection fraction |
