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目的 评价99Tcm-替曲膦MPI对冠心病的诊断价值.方法 对73例临床怀疑冠心病的患者[男46例,女27例,年龄(61.16±12.95)岁],行99Tcm-TF MPI,第1天行静息显像,次日行运动或药物负荷显像.1周内行CAG,以其结果为“金标准”,计算99Tcm-TF MPI诊断冠心病的灵敏度、特异性和准确性等.结果 在73例患者中,43例CAG阳性,其中MPI阳性32例,阴性11例.单支病变27例,双支病变10例,三支病变6例.共65支病变血管,累及LAD 33支,LCX 16支,RCA 16支.30例CAG阴性,其中MPI阴性25例,阳性5例.99Tcm-TF MPI对冠心病诊断的灵敏度74.4％(32/43),特异性83.3％(25/30),阳性预测值86.5％(32/37),阴性预测值69.4％(25/36),准确性为78.1％(57/73).诊断单支、双支及三支病变患者的灵敏度分别为66.7％(18/27)、80.0％(8/10)和5/6.99Tcm-TF MPI诊断病变血管的灵敏度为67.7％(44/65),特异性为89.0％ (137/154).结论 99Tcm-TF MPI对冠心病有较好的诊断价值,是继99Tcm-MIBI之后又一优良的心肌灌注显像剂.

Objective To assess the clinical value of 99Tcm-tetrofosmin (TF) MPI for diagnosis of CHD.Methods A total of 73 patients (46 males,27 females; age:(61.16 ± 12.95) y) were included in this study.99Tcm-TF MPI and CAG were performed in all patients.Two-day protocol of MPI was used in this study,with rest MPI performed on the first day and stress (exercise stress or adenosine stress) imaging on the next day.CAG was performed within one week after MPI and served as the gold standard in diagnosis of CHD.Stenosis over 50％ of the lumen was considered positive.The diagnostic efficacy of 99Tcm-TF MPI was evaluated based on the results of CAG.Results Among the 73 patients,43 patients were CAG positive,27 cases with single vessel disease,10 patients with double vessel disease and 6 patients with triple vessel disease.There were 37 patients with abnormality in MPI and 36 patients with normal MPI.Out of 43patients with positive CAG,there were 32 cases diagnosed with myocardial ischemia and 11 with normal results in MPI.Among the 65 diseased vessels,there were 33 involved in LAD,16 LCX and 16 RCA.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of MPI for detection of CHD were 74.4％ (32/43),83.3％ (25/30),86.5％ (32/37),69.4％ (25/36) and 78.1％ (57/73),respectively.The sensitivities for detection of single vessel disease,double vessel disease and triple vessel disease were 66.7％ (18/27),80.0％ (8/10) and 5/6,respectively.The sensitivity and specificity of MPI for detection of coronary disease in all 219 vessels were 67.7％ (44/65) and 89.0％ (137/154),respectively.Conclusion 99Tcm-TF MPI,with convenient preparation and reliable properties of the tracer,may provide an alternative modality for accurate detection of CHD.