應用雙同位素休息相鉈－201與壓力相鎝－99m sestamibi心肌灌注造影診斷冠狀動脈疾病

The Application of Dual-isotope Rest Thallium-201/Stress Technetium-99m Myocardial Perfusion Imaging in Diagnosis of Coronary Artery Disease

鄭時維(Shih-Wei Cheng) ； 徐健欽(Chien-Chin Hsu) ； 方淑屏(Shu-Ping Fang) ； 邱志宏(Jih-Hung Chiu)

《台灣應用輻射與同位素雜誌》 5卷3期 (2009/09) Pp. 721-727

https://doi.org/10.29832/TJARI.200909.0004

摘要

本研究目的在於評估雙同位素休息相鎝－201與壓力相鎝－99m sestamibi這種心肌灌注造影流程應用於臨床診斷冠狀動脈疾病的結果。本回溯性研究選取從2005年1月到2006年12月間413位因爲懷疑冠狀動脈疾病在本院進行雙同位素心肌灌注造影的病人（男性197位，女性216位，平均年齡67±11歲，年齡範圍35到91歲），雙同位素心肌灌注造影結果不正常有114位(27.6%)，正常有299位(72.4%)，其中有34位病人（男性17位，女性17位，平均年齡64±12歲，年齡範圍35-85歲）在心肌灌注造影檢查後6個月內有進行心導管冠狀動脈攝影，我們以冠狀動脈管徑狹窄超過50%作爲診斷冠狀動脈疾病的標準，21位心肌灌注造影不正常的病人，心導管檢查結果有19位爲冠狀動脈疾病，13位心肌灌注造影判讀爲正常的病人，心導管檢查結果只有2位爲冠狀動脈疾病，雙同位素心肌灌注造影檢查對冠狀動脈疾病診斷的靈敏度爲90.5%、特異度爲84.6%、陽性預測值爲90.5%、陰性預測值爲84.6%、正確率爲88.2%。因此，我們的結論是雙同位素休息相鉈－201與壓力相鎝－99m sestamibi心肌灌注造影流程應用於臨床上診斷冠狀動脈疾病，是一種相當準確的方法。

關鍵字

冠狀動脈疾病 ； 心肌灌注掃描造影流程 ； 雙向位素心肌灌注掃描 ； 鉈－201 ； 鎝－99m seastamibi

並列摘要

The purpose of this study was to evaluate the application of dual-isotope rest thallium-201/stress technetium-99m sestamibi myocardial perfusion imaging (dual-isotope MPI) protocols in diagnosis of coronary artery disease (CAD) From Jan. 2005 to Dec 2006, 413 patients (197 male and 216 female; mean age 67±11 years, range from 35 to 91 years) with unknown CAD underwent dual-isotope MPI protocol in our hospital were enrolled in this retrospective study. The results of dual-isotope MPI were abnormal in 114 patients (27.6%) and normal in 299 patients (72.4%). There were 34 patients (17 men and 17 female; mean age 64±12 years, range from 35 to 85 years) underwent subsequent coronary angiography within six months. A luminal-diameter stenosis of greater than 50% was considered as significant CAD. Of the 21 patients with abnormal dual-isotope MPI, 19 patients had significant CAD in coronary angiography. Of the 13 patients with normal dual-isotope MPI, only 2 patients had significant CAD in coronary angiography. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90.5%, 84.6%, 90.5%, 84.6%, and 88.2%, respectively. In conclusion, dual-isotope MPI protocol was an accurate procedure for the diagnosis of CAD.

並列關鍵字

coronary artery disease ； myocardial perfusion imaging protocol ； dual-isotope myocardial perfusion imaging ； thallium-201 ； technetium-99m