99mTc-N-NOET运动心肌灌注显像诊断冠状动脉疾病

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (03): 337-338.

^99mTc-N-NOET运动心肌灌注显像诊断冠状动脉疾病

欧阳伟, 何国荣, 刘金华

第一军医大学珠江医院核医学科, 广东, 广州, 510282

出版日期:2004-03-20 发布日期:2004-03-20
基金资助:
收稿日期:2002-12-6。
作者简介:欧阳伟(1963- ),男,1998年毕业于第一军医大学,硕士,主治医师,讲师,电话:020-61643477,E-mail:oyw88@163.net

^99mTc-N-NOET myocardial perfusion imaging during exercise for diagnosis of coronary artery disease

OUYANG Wei, HE Guo-rong, LIU Jin-hua

第一军医大学珠江医院核医学科, 广东, 广州, 510282

Online:2004-03-20 Published:2004-03-20

摘要/Abstract

摘要： 目的探讨^99mTc-N-NOET( NOET) 运动肺/心比值对冠状动脉疾病(CAD)多支病变的诊断价值及其与左室舒张功能的相关性。方法对49例经冠状动脉造影病人进行NOET运动-延迟心肌灌注断层显像,其中29例经冠状动脉造影证实动脉狭窄≥50%,20例冠状动脉正常。结果 NOET运动心肌灌注断层显像对CAD的诊断敏感性和特异性分别为86.2%和95.0%。多支病变组(0.76±0.13)NOET运动肺/心比值显著高于单支病变(0.62±0.06)和冠脉正常组(0.58±0.13)(F=18.04,P=0.002-0.001)。当NOET运动肺/心比值≥0.70时,其对冠脉多支病变的诊断敏感性和特异性分别为93.5%和83.3%。NOET运动肺/心比值与E/A比值具有非常显著的负相关性(r=-0.771, P<0.000 1)。结论 NOET运动肺/心比值对CAD病人的多支病变和左室舒张功能异常均具有诊断价值。

Abstract: Objective To investigate the value of ^99mTc-N-NOET(NOET) myocardial perfusion imaging during exercise in the diagnosis of coronary artery disease (CAD), and the relationship between exercise NOET lung/heart ratio and left ventricular diastolic function. Methods Exercise-delayed NOET myocardial perfusion imaging was performed in 49 patients undergoing coronary angiography, among whom 29 had coronary stenosis≥50% and 20 normal coronary artery. Results The sensitivity and specificity of exercise NOET myocardial perfusion imaging were 86.2% and 95.0%, respectively, in the detection of CAD. The NOET lung/heart ratio of CAD patients with multiple branch involvement (0.76±0.13) was significantly higher than those of patients with single branch lesion (0.62±0.06) and with normal coronary artery (0.58±0.13, F=18.04, P=0.002-0.001). When the lung/heart ratio was over 0.70, the sensitivity and specificity of the imaging for detecting the presence of multiple branch involvement were 93.5% and 83.3%, respectively. NOET lung/heart ratio showed a significant correlation with E/A ratio (r=-0.771, P<0.000 1). Conclusion Exercise NOET lung/heart ratios has diagnostic values for multiple branch lesions and left ventricular diastolic function abnormalities in patients with CAD.

中图分类号:

R817.4

欧阳伟, 何国荣, 刘金华. ^99mTc-N-NOET运动心肌灌注显像诊断冠状动脉疾病[J]. 南方医科大学学报, 2004, 24(03): 337-338.

OUYANG Wei, HE Guo-rong, LIU Jin-hua. ^99mTc-N-NOET myocardial perfusion imaging during exercise for diagnosis of coronary artery disease[J]. Journal of Southern Medical University, 2004, 24(03): 337-338.

参考文献

[1] 欧阳伟,何国荣,刘金华,等.^99mTc-N-NOET的心肌摄取和分布及其初步临床应用[J].第一军医大学学报,2001,21(8):608-12.OuYang W, He GR, Liu JH, et al. Myocardial uptake and distribu tion of ^99mTc-N-NOET and it’s preliminary clinical application [J]. J First Mil Med Univ/Di Yi Jun Yi Da Xue Xue Bao, 2001, 21 (8): 608-12.
[2] Vanzetto G, Calnon DA, Ruiz M, et al. Myocardial uptake and redis tribution of ^99mTc-N-NOET in dogs with either sustained coronary low flow or transient coronary occlusion: comparison with 201Ti and myocardial blood flow[J]. Circulation, 1997, 96(7): 2325-31.
[3] Fagret D, Marie PY, Brunotte F, et al. Myocardial perfusion imaging with techetium ^99mTc-NOET: comparison with thallium-201 and coronary angiography[J]. J Nucl Med, 1995, 36(6): 936-43.
[4] 欧阳伟,何国荣,刘金华.冠状动脉疾病危险因素与²⁰¹Ti心肌灌注显像的相关性研究[J].第一军医大学学报,2002,22(12):1123-5.OuYang W, He GR, Liu JH. Relationship between risk factors for coronary artery disease and thallium-201 myocardial scintigraphy[J]. J First Mil Med Univ/Di Yi Jun Yi Da Xue Xue Bao, 2002, 22 (12): 1123-5.
[5] 韩显敏,刘保平,孙红卫,等.^99mTc-MIBI脑显像评价胶质瘤恶性程度[J].河南医科大学学报,2001,36(2):167-8.Han XM, Liu BP, Sun HE, et al. ^99mTc-MIBI brain imaging in evalu ating the malignant grade ofgliomas[J]. J Henan Med Univ, 36(2): 167-8.
[6] Eartinez EE, Horowitz SF, Castello HJ, et al. Lung and myocardialthallium-201 kinetics in resting patients with congestive heart fail ure: correlation with pulmonary capillary wedge pressure [J]. Am Heart J, 1992;123(2): 427-32.
[7] 欧阳伟,何国荣,刘金华,等.运动²⁰¹Ti肺/心比值对高血压合并冠状动脉疾病中的临床价值[J].中华核医学杂志,2002,22(5): 302-4.OuYang W, HeGR, Liu JH, et al. Clinical value of ²⁰¹Ti lung/heart ratio during exercise in hypertensive patients with coronary artery disease[J]. Chin J Nucl Med, 2002, 22(5): 302-4.