建立國人鉈-201心肌血流灌注掃描定量化的正常資料庫及其診斷冠狀動脈疾病的臨床效益

Clinical Efficacy of Quantitative Dobutamine Thallium-201 SPECT in Diagnosis of Coronary Artery Disease Detected by Taiwanese Normal Database

林明賢(Ming-Hsien Lin) ； 曹勤和(Chin-Ho Tsao) ； 洪慧意(Huey-Yi Hung) ； 黃文盛(Wen-Sheng Huang) ； 鄭澄意(Cheng-Yi Cheng) ； 留以堅(Yi-Chien Liu) ； 柯景塘(Chin-Tang Ko)

《核子醫學雜誌》 17卷3期 (2004/09) Pp. 131-138

摘要

Background: There are two methods in performing 201T1 myocardial perfusion study; that is, treadmill exercise stress and pharmacological stress. Pharmacological stress (including dobutamine, dipyridamole and adenosine) can be used in those patients who cannot perform treadmill exercise test. The aim of this study is to set up the quantitative Taiwanese normal data (Bull’s eye polar map) of dobutamine 201T1 myocardial perfusion study (DTS). We also compare the Taiwanese normal database (TN), foreign data by Cedar-Sinai polar map (CS) and visual inspection (VI) in the sensitivity, specificity and accuracy for diagnosis of coronary artery disease (CAD).
Methods: From June. 1995 to Aug. 1996, there were 890 subjects (476 men, mean aged 64±12 years; 414 women, mean aged 65±10 years) performing DTS. Among them, 89 subjects accept cardiac catheterization to evaluate the efficacy of DTS in diagnosis of CAD. We selected the patients who bad less than 5% likelihood of CAD (no risk factors of CAD and normal EKG or treadmill exercise test) from the cardiovascular outpatient department. There were 51 subjects in our normal data, mean aged 52±12 years (35-75 years): 30 men, aged 54±13 years and 21 women, aged 50±10 years.
Results: The accuracy of TN, CS and VI in diagnosing left anterior descending artery (LAD) CAD is 83%、72% and 74%, respectively. The accuracy in TN, CS and VI for left circumflex artery (LCX) is 74%、66%、64%, respectively. The accuracy in TN, CS and VI for right coronary artery (RCA) is 73%、70%、75%, respectively.
Conclusion: Quantitative DTS adjusted by Taiwan normal database can improve the diagnosis of left anterior descending artery CAD as comparison with CS and VI.

關鍵字

dodutamine ； 鉈-201 ； 冠狀動脈疾病 ； 定量化正常資料庫

並列摘要

Background: There are two methods in performing 201T1 myocardial perfusion study; that is, treadmill exercise stress and pharmacological stress. Pharmacological stress (including dobutamine, dipyridamole and adenosine) can be used in those patients who cannot perform treadmill exercise test. The aim of this study is to set up the quantitative Taiwanese normal data (Bull’s eye polar map) of dobutamine 201T1 myocardial perfusion study (DTS). We also compare the Taiwanese normal database (TN), foreign data by Cedar-Sinai polar map (CS) and visual inspection (VI) in the sensitivity, specificity and accuracy for diagnosis of coronary artery disease (CAD).
Methods: From June. 1995 to Aug. 1996, there were 890 subjects (476 men, mean aged 64±12 years; 414 women, mean aged 65±10 years) performing DTS. Among them, 89 subjects accept cardiac catheterization to evaluate the efficacy of DTS in diagnosis of CAD. We selected the patients who bad less than 5% likelihood of CAD (no risk factors of CAD and normal EKG or treadmill exercise test) from the cardiovascular outpatient department. There were 51 subjects in our normal data, mean aged 52±12 years (35-75 years): 30 men, aged 54±13 years and 21 women, aged 50±10 years.
Results: The accuracy of TN, CS and VI in diagnosing left anterior descending artery (LAD) CAD is 83%、72% and 74%, respectively. The accuracy in TN, CS and VI for left circumflex artery (LCX) is 74%、66%、64%, respectively. The accuracy in TN, CS and VI for right coronary artery (RCA) is 73%、70%、75%, respectively.
Conclusion: Quantitative DTS adjusted by Taiwan normal database can improve the diagnosis of left anterior descending artery CAD as comparison with CS and VI.

並列關鍵字

dobutamine ； thallium-201 ； coronary artery disease ； Bull's eye normal database