【摘要】 目的比较腺苷超声心动图与腺苷核素心肌灌注显像诊断冠心病及推测稳定型心绞痛患者相关狭窄血管的价值。方法51例临床诊断为稳定型心绞痛的住院患者同期进行腺苷超声心动图与腺苷核素心肌灌注显像检查,超声心动图示室壁运动障碍,心肌显像检测核素分布稀疏或缺损,并在2周内行冠状动脉造影对照。结果51例患者接受冠状动脉造影,诊断冠心病42例,9例排除冠心病,诊断狭窄血管74支。超声心动图阳性者33例,心肌显像阳性者39例。超声心动图诊断狭窄血管敏感性62%,特异性86%,准确性75%。核素心肌显像诊断狭窄血管敏感性80%,特异性89%,准确性84%。二者诊断符合率84%。结论研究结果显示,与腺苷超声心动图诊断稳定型心绞痛患者狭窄血管相比较,腺苷心肌灌注显像具有更高的敏感性,尤其识别多支病变及中重度狭窄血管更敏感。更多还原

【Abstract】 Objective This study compared the results of adenosine SPECT with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed coronary vessels.Methods Fifty-one consecutive patients with suspected or known UA had simultaneous adenosine (140 μg·Kg-1·min-1 intravenously) with SPECT and echocardiography.All patients had coronary angiography within 2 wk from imaging studies.Results At coronary angiography,9 patient had normal coronary vessels,42patients had stenosis coronary vessels(≥50% luminal stenosis ).Among the 42 patients with CAD,39 showed myocardial perfusion defects at adenosine SPECT (sensitivity 93%) and 33 had abnormal wall motion abnormality (sensitivity 79%).Overall sensitivity,specificity and diagnostic accuracy for detection of individual stenosed vessels were 80%,89% and 84% for SPECT,and 62%,86% and 75% for echocardiography.Concordance between adenosine SPECT and echocardiography in detecting individual stenosed coronary vessels was observed in 128 (84%) of the 153 vascular territories,with a kappa value of 0.52.Conclusions Adenosine-induced coronary vasodilation associated with SPECT is more sensitive than adenosine echocardiography in detecting individual stenosed coronary vessels.In patients with multivessel disease and severe luminal stenosis,Sensitivity in the identification of individual stenosed coronary arteries were significantly higher for SPECT as compared to echocardiography.更多还原