腺苷负荷13N-NH3 PET心肌灌注显像结合冠状动脉CTA诊断冠心病
Integration of 13N-NH3 PET myocardial perfusion imaging and coronary CT angiography in the diagnosis of coronary artery disease
目的 评价腺苷负荷13N-NH3PET心肌灌注显像(MPI)与CT冠状动脉造影(CTA)相结合对提高冠心病(CAD)诊断准确性的临床应用价值.方法 对25例怀疑CAD的患者同时行腺苷负荷13N-NH3MPI及CTA,1个月内行导管法冠状动脉造影(CAG).结果 (1)25例患者共300个冠状动脉节段,CTA显示良好节段为263个,显示率(显示良好节段所占百分比)达87.7%.(2)25例患者CTA、MPI及CTA+MPI诊断CAD的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为82.1%(23/28),87.5%(14/16)及93.8%(15/16);93.2%(219/235),8/9及9/9;92.O%(242/263),88.0%(22/25)及96.0%(24/25);58.9%(23/29),93.3%(14/15)及100.0%(15/15);97.8%(219/224),8/10及9/10.结论 PET/CT实现了同机腺苷负荷"N-NH3PET心肌灌注显像与CTA相结合,提高了诊断CAD的准确性.
更多Objective An accurate, noninvasive technique for the diagnosis of coronary artery dis-ease (CAD) should provide complementary information on coronary anatomy and pathophysiology of lesions.This paper present the results of integrated PET/CT for combined acquisition of coronary anatomy and myo-cardial perfusion for the diagnosis of CAD. Methods On a PET/CT scanner, contrast enhanced CT angi-ography (CTA) and rest/adenosine-stress myocardial perfusion imaging (MPI) with 13N ammonia were per-formed on 25 patients who were suspected of having CAD. All these patients underwent selective coronary angingraph (CAG) within one month of PET/CT study. Results Of the 300 coronary artery segments in 25 patients, 263 coronary artery segments were considered possible to be evaluated by CTA (87.7%). In the 25 patients, the sensitivity, specificity, accuracy, positive and negative predictive values of CTA alone,PET (MPI) alone and PET (MPI) plus CTA were 82.1% (23/28), 87.5% (14/16), 93.8% (15/16); 93.2% (219/235), 88.9% (8/9) and 100.0% (9/9); 92.0%(242/263), 88.0%(22/25) and 96.0% (24/25); 58.9% (23/29), 93.3% (14/15) and 100.0% (15/15); 97.8% (219/224), 80% (8/10) and 90% (9/10), respectively. Conclusion Combination of PET and CTA are superior to either CAT alone or PET alone in diagnosis of CAD.
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