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目的 比较心肌灌注断层显像 (MPI)和电子束CT(EBCT)诊断 >45岁与≤ 45岁冠心病(CAD)患者的价值。方法 将 6 4例临床拟诊为CAD的患者按年龄分为A组 (>45岁 ,40例 )和B组(≤ 45岁 ,2 4例 )。均进行EBCT探查冠状动脉钙化、99Tcm 甲氧基异丁基异腈 (MIBI)MPI和冠状动脉造影 (CAG)。其中 ,A、B组中分别有 31例和 14例患者有≥ 5 0 %的冠状动脉狭窄。以有无≥ 5 0 %的冠状动脉狭窄为判断EBCT和MPI诊断准确性的标准。结果 所有MPI异常并有冠状动脉钙化的患者都有≥ 5 0 %冠状动脉狭窄 ,93 3%MPI和EBCT正常的患者冠状动脉无狭窄。MPI诊断B组患者CAD的灵敏度显著高于EBCT(92 9%与 42 9% ,P <0 0 1) ,而特异性两者相近 ;MPI和EBCT诊断A组患者CAD的特异性分别为 88 9%和 5 5 6 % ,灵敏度相近。MPI诊断A、B组冠状动脉≥ 5 0 %狭窄的特异性均显著高于EBCT(分别为 94 1%比 6 6 7% ,P <0 0 0 1和 85 7%比 38 1% ,P <0 0 0 5 )。结论 99Tcm MIBIMPI诊断≤ 45岁CAD的灵敏度和诊断 >45岁CAD的特异性高于EBCT ,结合两种检查可能使CAD诊断的准确性进一步提高。
Objective To compare the diagnostic value of myocardial perfusion imaging (MPI) and electron beam computed tomography (EBCT) in patients with coronary heart disease (CAD) aged 45 and 45 years. Methods Sixty-four patients who were clinically diagnosed as CAD were divided into A group (> 45 years old and 40 cases) and B group (≤ 45 years old, 24 cases) by age. Coronary artery calcification, 99Tcm MIBI MPI and coronary angiography (CAG) were performed by EBCT. Among them, 31 cases in group A and 14 cases had ≥50% coronary stenosis. To determine the accuracy of diagnosis of EBCT and MPI with ≥50% of coronary artery stenosis. Results All patients with MPI abnormalities and coronary artery calcification had ≥50% coronary artery stenosis, and 93.3% of patients with normal MPI and EBCT had no coronary artery stenosis. The sensitivity of MPI in diagnosis of group B was significantly higher than that of EBCT (92.9% vs 42.9%, P <0.01), but the specificity was similar between group B and group B. The specificity of CAD in group A and group C was 88 9 % And 556%, the sensitivity is similar. The specificity of MPI in diagnosis of ≥50% stenosis of coronary artery in group A and B were significantly higher than that in EBCT (94 1% vs 667%, P 0 01 and 85 7% vs 38 1%, P < 0 0 0 5). Conclusions The sensitivity and diagnosis of 99Tcm MIBIMPI for diagnosis of CAD ≤ 45 years> The specificity of 45-year-old CAD is higher than that of EBCT. Combined with the two tests, the diagnostic accuracy of CAD may be further improved.