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冠心病心肌缺血、坏死程度的磁共振与单光子发射计算机体层显像对照研究
何东1,王莉1*,朱海云2,林琳1,田建明1,孔令山1
0
(1.第二军医大学长海医院放射科,上海 200433;2.解放军第85医院放射科,上海 200052)
摘要:
目的:评估磁共振(MRI)和单光子发射计算机体层显像(SPECT)检测心肌缺血、坏死的价值。方法:冠心病拟行血运重建术患者28例,于术前1周内完成冠状动脉造影(CAG)、MRI和SPECT的对照检查,以CAG结果狭窄程度≥70%为标准,判断MRI和SPECT检出心肌缺血、坏死的敏感性、特异性和准确性。结果:CAG发现阳性血管共39支,阴性血管共45支。以CAG结果为标准,MRI检出心肌缺血的敏感度、特异度、准确度分别为92.31%、80.00%、85.71%,检出心肌坏死的敏感度、特异度、准确度分别为66.67%、91.11%、79.76%;SPECT检出心肌缺血的敏感度、特异度、准确度分别为94.87%、82.22%、88.10%,检出心肌坏死的敏感度、特异度、准确度分别为61.54%、86.67%、75.00%。统计学分析表明,MRI和SPECT显示缺血和坏死与CAG对照无明显差别,并且MRI和SPECT两种方法判断心肌缺血和坏死的准确度差异无明显统计学意义。结论:以CAG管腔狭窄程度≥70%为临界值,MRI与SPECT检出相应供血区心肌缺血、坏死的准确度较高,两者具有很好的一致性。
关键词:  冠状动脉疾病  磁共振成像  体层摄影术,发射型计算机,单光子
DOI:10.3724/SP.J.1008.2007.01082
基金项目:国家自然科学基金(30270419).
MRI and SPECT in evaluating myocardial ischemia and necrosis in patients with coronary artery disease: a comparative study
HE Dong1, WANG Li1*, ZHU Haiyun2, LIN Lin1, TIAN Jianming1, KONG Lingshan1
(1.Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China; 2.Department of Radiology, No. 85 Hospital of PLA, Shanghai 200052)
Abstract:
Objective:To assess the value of MRI and single photon emission computed tomography (SPECT) in detecting myocardial ischemia and necrosis. Methods: Coronary angiography (CAG), MRI and SPECT were performed in 28 patients with coronary artery disease one week before revascularization operation. The stenosis criterion was a more than 70% stenosis by CAG; the sensitivity,specificity and accuracy of both MRI and SPECT were calculated according to the criterion. Results: CAG revealed 39 positive arteries and 45 negative arteries. According to the CAG results, the sensitivity, specificity and accuracy of MRI for detecting myocardial ischemia were 92.31%, 80.00% and 85.71%, respectively; and for detecting myocardial necrosis were 66.67%, 91.11%, and 79.76%, respectively. The sensitivity, specificity and accuracy of SPECT for detecting myocardial ischemia were 94.87%, 82.22% and 88.10%, respectively; and for detecting myocardial necrosis were 61.54%, 86.67%, and 75.00%, respectively.Conclusion: MRI and SPECT have high accuracy in detecting myocardial ischemia and necrosis and the results of the 2 methods accord well with each other.
Key words:  coronary diseases  magnetic resonance imaging  tomography, emission computed, single photon